Healthcare Provider Details

I. General information

NPI: 1376356618
Provider Name (Legal Business Name): TALEAH PIEHL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 BANNOCK ST
DENVER CO
80204-4506
US

IV. Provider business mailing address

11421 UPTOWN AVE APT 314
BROOMFIELD CO
80021-4185
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-6000
  • Fax:
Mailing address:
  • Phone: 678-646-4917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA.0015626
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: