Healthcare Provider Details

I. General information

NPI: 1376596437
Provider Name (Legal Business Name): PATRICIA ANN HUTT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 S KIPLING ST
LAKEWOOD CO
80227-2126
US

IV. Provider business mailing address

3812 SIMMS ST
WHEAT RIDGE CO
80033-3800
US

V. Phone/Fax

Practice location:
  • Phone: 720-963-5382
  • Fax: 720-963-5380
Mailing address:
  • Phone: 303-421-2270
  • Fax: 303-409-2233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2287
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: