Healthcare Provider Details

I. General information

NPI: 1265924997
Provider Name (Legal Business Name): GRACE SCHWEMMER PT, DPT, ATC, CSCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7340 S ALTON WAY
CENTENNIAL CO
80112-2335
US

IV. Provider business mailing address

7340 S ALTON WAY
CENTENNIAL CO
80112-2335
US

V. Phone/Fax

Practice location:
  • Phone: 720-493-1181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0015628
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: