Healthcare Provider Details

I. General information

NPI: 1033460613
Provider Name (Legal Business Name): NICHOLAS THURLOW PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2012
Last Update Date: 12/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3989 E ARAPAHOE RD STE 216
CENTENNIAL CO
80122-2077
US

IV. Provider business mailing address

6834 S UNIVERSITY BLVD SUITE 141
CENTENNIAL CO
80122-1515
US

V. Phone/Fax

Practice location:
  • Phone: 720-644-0181
  • Fax: 720-381-6868
Mailing address:
  • Phone: 720-644-0181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11791
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: