MEDICARE: MISS NICOLE MARIE WEBB PHYSICAL THERAPIST

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	7330	CO

General Provider Information

NPI Number	:	1063514255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS NICOLE MARIE WEBB PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	3401 QUEBEC ST
Second Line	:	SUITE 3100
City	:	DENVER
State	:	CO
Zip	:	80207-2322
Country	:	US
Telephone Number	:	303-333-3493
Fax Number	:	303-388-8990

Provider Business Practice Location Address
First Line	:	3401 QUEBEC ST
Second Line	:	SUITE 3100
City	:	DENVER
State	:	CO
Zip	:	80207-2322
Country	:	US
Telephone Number	:	303-333-3493
Fax Number	:	303-388-8990

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	10/13/2009

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