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General NPI Number Information
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NPI Number | 1548469984
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Entity Type | Individual
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Provider Name | MR. ROBERT CARL WALFORD
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Gender | Male
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 06/04/2009
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Provider Practice Location Address
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Address Line | 8227 S. HOLLY ST. PREMIER CARE PHYSICAL THERAPY
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City | CENTENNIAL
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State | CO
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Zip | 80122
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Country | US
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Telephone | 303-770-0250
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Fax | 303-770-0320
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Provider Business Mailing Address
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Address Line | 13918 E MISSISSIPPI AVE 337
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City | AURORA
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State | CO
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Zip | 80012-3603
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Country | US
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Telephone | 702-400-6916
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4677
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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 | 5729
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License Number State | CO
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