MEDICARE: GARY M. HARKNESS M.S.P.T.

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	5167	CA
2	2251X0800X	Orthopedic Physical Therapist	5167	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	102255330	OTHER		OWCP FACITLITY ID

General Provider Information

NPI Number	:	1194734541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY M. HARKNESS M.S.P.T.

Provider Business Mailing Address
First Line	:	2000 S. COLORADO BLVD THE COLORADO CENTER TOWER ONE
Second Line	:	SUITE 1000
City	:	DENVER
State	:	CO
Zip	:	80222
Country	:	US
Telephone Number	:	720-848-2000
Fax Number	:	720-848-8209

Provider Business Practice Location Address
First Line	:	2000 S. COLORADO BLVD THE COLORADO CENTER TOWER ONE
Second Line	:	SUITE 1000
City	:	DENVER
State	:	CO
Zip	:	80222
Country	:	US
Telephone Number	:	720-848-2000
Fax Number	:	720-848-8209

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	04/03/2020

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Directions to “ GARY M. HARKNESS M.S.P.T.” Practice Location

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