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General NPI Number Information
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NPI Number | 1932996980
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Entity Type | Organization
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Legal Business Name | COLORADO PATRICK, LLC
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 8085 S CHESTER ST # 204
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City | CENTENNIAL
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State | CO
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Zip | 80112-3543
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Country | US
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Telephone | 850-591-1158
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Fax |
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Provider Business Mailing Address
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Address Line | 1090 S WADSWORTH BLVD STE C
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City | LAKEWOOD
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State | CO
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Zip | 80226-4350
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Country | US
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Telephone | 850-591-1158
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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 | MR. CHARLES PATRICK
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Credential | PT
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Telephone | 850-591-1158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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