Healthcare Provider Details

I. General information

NPI: 1548184831
Provider Name (Legal Business Name): RHETT GULOTTA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17351 DRAKE ST
BROOMFIELD CO
80023-5205
US

IV. Provider business mailing address

8342 N MARYS LN
LA PORTE IN
46350-7027
US

V. Phone/Fax

Practice location:
  • Phone: 303-908-0500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number21308
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: