Healthcare Provider Details

I. General information

NPI: 1831026020
Provider Name (Legal Business Name): FUNCTIONAL PERFORMANCE PT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 JULIAN ST UNIT C102
DENVER CO
80204-2643
US

IV. Provider business mailing address

6169 S BALSAM WAY STE 110
LITTLETON CO
80123-3000
US

V. Phone/Fax

Practice location:
  • Phone: 303-948-1868
  • Fax: 303-948-1741
Mailing address:
  • Phone: 303-948-1868
  • Fax: 303-948-1741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANGELA REICH
Title or Position: OWNER
Credential:
Phone: 303-948-1868