Healthcare Provider Details

I. General information

NPI: 1275496622
Provider Name (Legal Business Name): TERESA SHULTZ PT, DPT
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S COLORADO BLVD STE 640
GLENDALE CO
80246-1239
US

IV. Provider business mailing address

1211 VINE ST APT 601
DENVER CO
80206-2940
US

V. Phone/Fax

Practice location:
  • Phone: 303-320-4450
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0019608
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: