Healthcare Provider Details

I. General information

NPI: 1437944402
Provider Name (Legal Business Name): HARRISON DAVID CRUZ DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 E FLORIDA AVE STE 917
DENVER CO
80210-2549
US

IV. Provider business mailing address

5872 WALSH PT APT 306
COLORADO SPRINGS CO
80919-2014
US

V. Phone/Fax

Practice location:
  • Phone: 844-757-7450
  • Fax:
Mailing address:
  • Phone: 972-489-3440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPTL.0020464
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: