Healthcare Provider Details

I. General information

NPI: 1992428783
Provider Name (Legal Business Name): ERIC ANDREW MAKUCH DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26367 CONIFER RD
CONIFER CO
80433-9140
US

IV. Provider business mailing address

26367 CONIFER RD
CONIFER CO
80433-9140
US

V. Phone/Fax

Practice location:
  • Phone: 303-838-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0021416
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT39446
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: