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General NPI Number Information
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NPI Number | 1164510038
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Entity Type | Organization
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Legal Business Name | PURPOSE MEDICAL PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 2828 W 44TH AVE
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City | DENVER
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State | CO
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Zip | 80211-1429
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Country | US
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Telephone | 303-477-5303
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Fax | 303-477-5302
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Provider Business Mailing Address
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Address Line | 2828 W 44TH AVE
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City | DENVER
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State | CO
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Zip | 80211-1429
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Country | US
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Telephone | 303-477-5303
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Fax | 303-477-5302
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICK OLDERMAN
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Credential | MSPT, CPT
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Telephone | 303-477-5303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 5852
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License Number State | CO
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