MEDICARE: CONOR WILLIAM SPARACIO PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PTA.0015152	CO

General Provider Information

NPI Number	:	1043153083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONOR WILLIAM SPARACIO PTA

Provider Business Mailing Address
First Line	:	7918 S DEPEW ST APT C
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80128-8422
Country	:	US
Telephone Number	:	303-432-8487
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 E CHERRY CREEK SOUTH DR STE 725
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80246-1518
Country	:	US
Telephone Number	:	303-432-8487
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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