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General NPI Number Information
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NPI Number | 1649737149
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Entity Type | Individual
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Provider Name | LUCAS CHARLES HANERHOFF PT, DPT, ATC
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Gender | Male
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 420 E 120TH AVE STE B9
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City | NORTHGLENN
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State | CO
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Zip | 80233-1100
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Country | US
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Telephone | 303-280-3838
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Fax |
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Provider Business Mailing Address
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Address Line | 420 E 120TH AVE STE B9
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City | NORTHGLENN
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State | CO
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Zip | 80233-1100
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Country | US
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Telephone | 303-280-3838
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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.0020876
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 24-01534
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License Number State | KS
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