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General NPI Number Information
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NPI Number | 1831870591
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Entity Type | Organization
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Legal Business Name | ROGUE PHYSICAL THERAPY LTD
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 4720 ELM CT
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City | DENVER
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State | CO
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Zip | 80211-1147
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Country | US
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Telephone | 650-339-1312
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Fax |
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Provider Business Mailing Address
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Address Line | 4720 ELM CT
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City | DENVER
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State | CO
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Zip | 80211-1147
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Country | US
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Telephone | 650-339-1312
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAITLIN FOVENYESSY
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Credential |
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Telephone | 650-339-1312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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