MEDICARE: NORTHMETRO PHYSICAL THERAPY AND WELLNESS PC

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	7772	CO

General Provider Information

NPI Number	:	1073546446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHMETRO PHYSICAL THERAPY AND WELLNESS PC

Provider Business Mailing Address
First Line	:	1160 E 130TH AVE
Second Line	:	UNIT B
City	:	THORNTON
State	:	CO
Zip	:	80241-3933
Country	:	US
Telephone Number	:	720-982-3783
Fax Number	:	303-452-3087

Provider Business Practice Location Address
First Line	:	2350 LIMON DR
Second Line	:	SUITE 258
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-7643
Country	:	US
Telephone Number	:	970-213-9579
Fax Number	:	970-282-1892

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JAMES ANTHONY MILANI
Credential	:	PT
Telephone Number	:	720-982-3783

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	01/30/2008

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