Healthcare Provider Details

I. General information

NPI: 1013787381
Provider Name (Legal Business Name): AMANDA MOSER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3140 VILLAGE VISTA DR UNIT 104
ERIE CO
80516-2529
US

IV. Provider business mailing address

1737 ZELDA LN
NORTHGLENN CO
80241-3820
US

V. Phone/Fax

Practice location:
  • Phone: 720-600-0370
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0019550
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: