Healthcare Provider Details

I. General information

NPI: 1023069374
Provider Name (Legal Business Name): JON S STROTHER P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7310 S ALTON WAY STE 6L
CENTENNIAL CO
80112-2334
US

IV. Provider business mailing address

700 17TH ST STE 1825
DENVER CO
80202-3502
US

V. Phone/Fax

Practice location:
  • Phone: 303-790-4495
  • Fax: 720-488-1988
Mailing address:
  • Phone: 719-347-9309
  • Fax: 719-347-9311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 9059
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: