Healthcare Provider Details

I. General information

NPI: 1164217592
Provider Name (Legal Business Name): MOVEWELL PHYSICAL THERAPY COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 BRIGGS ST # 202
ERIE CO
80516-5023
US

IV. Provider business mailing address

12873 CLEARVIEW ST
FIRESTONE CO
80504-5337
US

V. Phone/Fax

Practice location:
  • Phone: 720-537-6305
  • Fax:
Mailing address:
  • Phone: 720-537-6305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL VAN PORTFLIET
Title or Position: OWNER
Credential: DPT
Phone: 720-537-6305