Healthcare Provider Details

I. General information

NPI: 1194920231
Provider Name (Legal Business Name): JAMES ERIN ESTES PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 S DOWNING ST ST ANTHONY CENTRAL HOSPITAL
DENVER CO
80210
US

IV. Provider business mailing address

6982 MT BRUSH CR
HIGHLANDS RANCH CO
80130
US

V. Phone/Fax

Practice location:
  • Phone: 303-629-3511
  • Fax:
Mailing address:
  • Phone: 303-346-3829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA04108
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: