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General NPI Number Information
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NPI Number | 1023615309
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Entity Type | Individual
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Provider Name | PRESTON WOLFF PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 10/08/2020
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1800 E 30TH ST STE A
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City | FARMINGTON
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State | NM
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Zip | 87401-9040
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Country | US
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Telephone | 505-208-6280
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Fax |
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Provider Business Mailing Address
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Address Line | 929 SPRING RD
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City | DURANGO
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State | CO
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Zip | 81303-7688
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Country | US
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Telephone | 360-560-8763
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 16960
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-2025-0113
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License Number State | NM
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