Healthcare Provider Details

I. General information

NPI: 1508071556
Provider Name (Legal Business Name): LOIS I WEINER PT, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2007
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 E 130TH AVE UNIT B
THORNTON CO
80241-3933
US

IV. Provider business mailing address

1160 E 130TH AVE UNIT B
THORNTON CO
80241-3933
US

V. Phone/Fax

Practice location:
  • Phone: 720-982-3783
  • Fax: 888-313-1418
Mailing address:
  • Phone: 720-982-3783
  • Fax: 888-313-1418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number039291
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number9085
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: