Healthcare Provider Details

I. General information

NPI: 1871603373
Provider Name (Legal Business Name): MICHELLE WULF PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7340 S ALTON WAY 11-D
CENTENNIAL CO
80112-2335
US

IV. Provider business mailing address

9776 W. MORRAINE AVE
LITTLETON CO
80127
US

V. Phone/Fax

Practice location:
  • Phone: 720-493-1181
  • Fax: 720-493-1191
Mailing address:
  • Phone: 402-650-2458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: