Healthcare Provider Details
I. General information
NPI: 1629715750
Provider Name (Legal Business Name): EMILY HERBSTER JUNEAU DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/19/2022
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3801 E FLORIDA AVE STE 330
DENVER CO
80210-2546
US
IV. Provider business mailing address
3801 E FLORIDA AVE STE 330
DENVER CO
80210-2546
US
V. Phone/Fax
- Phone: 303-370-2670
- Fax: 303-370-2696
- Phone: 303-370-2670
- Fax: 303-370-2696
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 18349 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: