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General NPI Number Information
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NPI Number | 1003429440
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Entity Type | Organization
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Legal Business Name | POWER-UP PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 08/25/2020
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 2117 S BIRCH ST
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City | DENVER
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State | CO
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Zip | 80222-5017
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Country | US
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Telephone | 818-326-4817
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 S WASHINGTON ST
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City | DENVER
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State | CO
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Zip | 80210-4047
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | DR. GAVIN ONGSINGCO
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Credential | PT, DPT, OCS
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Telephone | 818-326-4817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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