Healthcare Provider Details

I. General information

NPI: 1386425379
Provider Name (Legal Business Name): METROPOLITAN PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2023
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 N US HIGHWAY 287 STE 190
LAFAYETTE CO
80026-8905
US

IV. Provider business mailing address

PO BOX 1350
ERIE CO
80516-1350
US

V. Phone/Fax

Practice location:
  • Phone: 303-665-2405
  • Fax: 303-648-6602
Mailing address:
  • Phone: 303-665-2405
  • Fax: 303-648-6602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: VINCENT PAUL CARMELLINI
Title or Position: PT, OWNER
Credential: PT, DPT, OCS, MTC
Phone: 303-665-2405