Healthcare Provider Details

I. General information

NPI: 1801526496
Provider Name (Legal Business Name): STEPHANIE HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W SOUTH BOULDER RD STE 100
LOUISVILLE CO
80027-1157
US

IV. Provider business mailing address

1129 W 85TH AVE
DENVER CO
80260-4759
US

V. Phone/Fax

Practice location:
  • Phone: 303-666-4151
  • Fax:
Mailing address:
  • Phone: 831-325-8414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0018430
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: