Healthcare Provider Details

I. General information

NPI: 1598869513
Provider Name (Legal Business Name): BRAD JAMES SCHOENTHALER MSPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 04/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 18TH ST SUITE 475 NORTH TOWER
DENVER CO
80202-2499
US

IV. Provider business mailing address

999 18TH ST SUITE 475 NORTH TOWER
DENVER CO
80202-2499
US

V. Phone/Fax

Practice location:
  • Phone: 303-295-1403
  • Fax: 303-297-3021
Mailing address:
  • Phone: 303-295-1403
  • Fax: 303-297-3021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT00009997
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number11-03512
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2005029540
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9446
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: