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General NPI Number Information
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NPI Number | 1730437476
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Entity Type | Individual
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Provider Name | MICHAEL JOHN BADE PT, PHD
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Gender | Male
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 3333 REGIS BLVD # G-4
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City | DENVER
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State | CO
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Zip | 80221-1154
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Country | US
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Telephone | 303-458-4985
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Fax |
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Provider Business Mailing Address
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Address Line | 3030 E 17TH AVE APT 17
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City | DENVER
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State | CO
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Zip | 80206-1622
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Country | US
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Telephone | 303-886-4077
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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 | 9977
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License Number State | CO
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