Healthcare Provider Details

I. General information

NPI: 1487046256
Provider Name (Legal Business Name): ATALIA DIQUINZIO PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2015
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 S EATON ST
LAKEWOOD CO
80226-3544
US

IV. Provider business mailing address

1598 S MICHIGAN WAY
DENVER CO
80219-4546
US

V. Phone/Fax

Practice location:
  • Phone: 303-935-1448
  • Fax: 303-935-1440
Mailing address:
  • Phone: 720-989-8183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number0013529
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: