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General NPI Number Information
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NPI Number | 1548069479
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Entity Type | Individual
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Provider Name | ANTHONY WILLIAM LAREAU PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 4550 MAIN ST UNIT 200
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City | WESTMINSTER
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State | CO
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Zip | 80031-5175
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Country | US
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Telephone | 720-497-6162
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Fax | 720-497-6723
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Provider Business Mailing Address
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Address Line | 3490 HAYDEN PL APT 3
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City | BOULDER
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State | CO
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Zip | 80301-1932
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Country | US
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Telephone | 608-225-8454
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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 | PTL.0020410
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License Number State | CO
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