Healthcare Provider Details

I. General information

NPI: 1114174109
Provider Name (Legal Business Name): MILE HIGH PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2008
Last Update Date: 02/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 UINTA WAY STE 110
DENVER CO
80230-7198
US

IV. Provider business mailing address

495 UINTA WAY STE 110
DENVER CO
80230-7198
US

V. Phone/Fax

Practice location:
  • Phone: 303-856-3299
  • Fax: 303-856-7787
Mailing address:
  • Phone: 303-856-3299
  • Fax: 303-856-7787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number6156
License Number StateCO

VIII. Authorized Official

Name: DR. PADEN WOLFE
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 303-856-3299