Healthcare Provider Details

I. General information

NPI: 1447489729
Provider Name (Legal Business Name): ADAM ENGEL PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2009
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF COLORADO BOULDER
BOULDER CO
80309-2546
US

IV. Provider business mailing address

UNIVERSITY OF COLORADO BOULDER
BOULDER CO
80309-0001
US

V. Phone/Fax

Practice location:
  • Phone: 303-492-5101
  • Fax: 303-492-6861
Mailing address:
  • Phone: 303-492-5101
  • Fax: 303-492-6861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0010459
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL-10459
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: