Healthcare Provider Details

I. General information

NPI: 1124103148
Provider Name (Legal Business Name): WILLIAM JAMES FELDHAKE PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 S PEARL ST SUITE 101
DENVER CO
80210-2645
US

IV. Provider business mailing address

1550 S PEARL ST SUITE 101
DENVER CO
80210-2645
US

V. Phone/Fax

Practice location:
  • Phone: 303-778-7246
  • Fax: 303-871-0830
Mailing address:
  • Phone: 303-778-7246
  • Fax: 303-871-0830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number7451
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: