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General NPI Number Information
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NPI Number | 1639595275
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Entity Type | Organization
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Legal Business Name | DYNAMIC RECOVERY PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 03/06/2014
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Last Update Date | 12/21/2020
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Provider Practice Location Address
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Address Line | 6901 S PIERCE ST # 320
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City | LITTLETON
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State | CO
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Zip | 80128-4552
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Country | US
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Telephone | 303-872-7240
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Fax | 303-872-7240
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Provider Business Mailing Address
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Address Line | 6901 S PIERCE ST # 320
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City | LITTLETON
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State | CO
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Zip | 80128-4552
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Country | US
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Telephone | 303-872-7240
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Fax | 303-872-7240
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Authorized Official
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Title or Position | OWNER
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Name | NANCY M. BONIFER
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Credential | PT, DPT, MS
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Telephone | 303-872-7240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 5399
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License Number State | CO
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