Healthcare Provider Details
I. General information
NPI: 1245041680
Provider Name (Legal Business Name): SELECT PHYSICAL THERAPY OF WEST DENVER LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/15/2025
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1230 W ASH ST UNIT A
WINDSOR CO
80550-4677
US
IV. Provider business mailing address
4714 GETTYSBURG RD
MECHANICSBURG PA
17055-4325
US
V. Phone/Fax
- Phone: 970-561-9090
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
MICHAEL
TARVIN
Title or Position: VICE PRESIDENT
Credential:
Phone: 717-972-1100