Healthcare Provider Details

I. General information

NPI: 1871287946
Provider Name (Legal Business Name): ERICK RUBEN SORTO DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12000 E 47TH AVE STE 404
DENVER CO
80239-3143
US

IV. Provider business mailing address

12000 E 47TH AVE STE 404
DENVER CO
80239-3143
US

V. Phone/Fax

Practice location:
  • Phone: 999-999-9999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0020528
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: