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NPI Code Detail

MEDICARE: PATRICK TIMOTHY LALANCETTE PTA

MEDICARE: PATRICK TIMOTHY LALANCETTE 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
1225200000XPhysical Therapy Assistant0014983CO

General Provider Information

NPI Number : 1194392993
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK TIMOTHY LALANCETTE PTA
Provider Business Mailing Address
First Line : 1129 RIDGEVIEW CIR
Second Line :
City : BROOMFIELD
State : CO
Zip : 80020-3447
Country : US
Telephone Number : 720-232-4395
Fax Number :
Provider Business Practice Location Address
First Line : 1107 W CENTURY DR
Second Line :
City : LOUISVILLE
State : CO
Zip : 80027-1693
Country : US
Telephone Number : 720-507-3447
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2021
Last Update Date : 06/09/2021

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