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General NPI Number Information
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NPI Number | 1821581471
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Entity Type | Organization
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Legal Business Name | FOOT TRACKS
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Dates
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Enumeration Date | 06/08/2018
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Last Update Date | 08/16/2018
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Provider Practice Location Address
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Address Line | 1120 N LINCOLN ST STE 907
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City | DENVER
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State | CO
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Zip | 80203
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Country | US
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Telephone | 303-210-1225
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Fax |
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Provider Business Mailing Address
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Address Line | 1907 W GIRTON AVE
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City | ENGLEWOOD
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State | CO
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Zip | 80110-2012
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Country | US
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Telephone | 303-210-1225
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. STEVEN VASQUEZ
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Credential | PT, DPT
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Telephone | 303-210-1225
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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.0013615
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License Number State | CO
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