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General NPI Number Information
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NPI Number | 1083018576
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Entity Type | Organization
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Legal Business Name | MIGHTY MILESTONES PEDIATRIC PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/13/2014
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 10895 W 31ST PL
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City | LAKEWOOD
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State | CO
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Zip | 80215-7152
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Country | US
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Telephone | 303-921-6878
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Fax |
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Provider Business Mailing Address
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Address Line | 10895 W 31ST PL
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City | LAKEWOOD
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State | CO
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Zip | 80215-7152
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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 | PHYSICAL THERAPIST
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Name | STEPHANIE STUMPF
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Credential | DPT
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Telephone | 303-921-6878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 9703
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License Number State | CO
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