Healthcare Provider Details

I. General information

NPI: 1962332031
Provider Name (Legal Business Name): EMILY DEMOSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9153 YARROW ST
WESTMINSTER CO
80021-4561
US

IV. Provider business mailing address

3 SPECKMAN CT
BOLINGBROOK IL
60440-9004
US

V. Phone/Fax

Practice location:
  • Phone: 303-424-4828
  • Fax:
Mailing address:
  • Phone: 630-908-0481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0021238
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: