Healthcare Provider Details

I. General information

NPI: 1568778694
Provider Name (Legal Business Name): PHILIPP SIMON HOECHST DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2010
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5855 E STAPLETON DR N #A-130
DENVER CO
80216-3318
US

IV. Provider business mailing address

5855 E STAPLETON DR N #A-130
DENVER CO
80216-3318
US

V. Phone/Fax

Practice location:
  • Phone: 303-271-7444
  • Fax: 303-371-7364
Mailing address:
  • Phone: 303-271-7444
  • Fax: 303-371-7364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10890
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: