Healthcare Provider Details

I. General information

NPI: 1427376763
Provider Name (Legal Business Name): VERTICAL MOTION PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 02/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 WHITMAN DR
EVERGREEN CO
80439-2210
US

IV. Provider business mailing address

3045 WHITMAN DR
EVERGREEN CO
80439-2210
US

V. Phone/Fax

Practice location:
  • Phone: 303-325-5329
  • Fax: 303-670-3323
Mailing address:
  • Phone: 303-325-5329
  • Fax: 303-670-3323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number20101192876
License Number StateCO

VIII. Authorized Official

Name: MR. JOSHUA D. WHITE
Title or Position: CLINIC OWNER, PT
Credential: MPT, MTC, ATC
Phone: 303-325-5329