Healthcare Provider Details

I. General information

NPI: 1184634776
Provider Name (Legal Business Name): DAVID A. DIGIACOMO PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DAVID A JAMES PT, DPT

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9108 W 6TH AVE
LAKEWOOD CO
80215-5121
US

IV. Provider business mailing address

313 DECINO PL
ERIE CO
80516-2493
US

V. Phone/Fax

Practice location:
  • Phone: 303-484-1232
  • Fax:
Mailing address:
  • Phone: 303-514-4554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7633
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: