Healthcare Provider Details

I. General information

NPI: 1124103155
Provider Name (Legal Business Name): FELDHAKE PHYSICAL THERAPY, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
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

7340 S ALTON WAY STE 11-D
CENTENNIAL CO
80112-2323
US

V. Phone/Fax

Practice location:
  • Phone: 303-778-7246
  • Fax: 303-871-0830
Mailing address:
  • Phone: 720-493-1181
  • Fax: 720-493-1191

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: MR. WILLIAM JAMES FELDHAKE
Title or Position: OWNER
Credential: PT
Phone: 720-493-1181