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General NPI Number Information
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NPI Number | 1346758497
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Entity Type | Individual
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Provider Name | ALEX GLADES DPT
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Gender | Male
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 1760 E KEN PRATT BLVD STE 405
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City | LONGMONT
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State | CO
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Zip | 80504-5311
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Country | US
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Telephone | 720-718-5400
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Fax | 720-718-5987
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Provider Business Mailing Address
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Address Line | 2695 ROCKY MOUNTAIN AVE
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City | LOVELAND
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State | CO
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Zip | 80538-8702
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Country | US
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Telephone | 970-624-1103
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Fax | 970-490-4156
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 0015322
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License Number State | CO
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