MEDICARE: HEALTHONE CLINIC SERVICES, LLC

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

General Provider Information

NPI Number	:	1376525642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHONE CLINIC SERVICES, LLC

Provider Business Mailing Address
First Line	:	5044 W 92ND AVE
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80031-6302
Country	:	US
Telephone Number	:	303-650-6520
Fax Number	:	303-427-2773

Provider Business Practice Location Address
First Line	:	5044 W 92ND AVE
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80031-6302
Country	:	US
Telephone Number	:	303-650-6520
Fax Number	:	303-427-2773

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. PATRICK BIRNINGHAM
Credential	:
Telephone Number	:	615-373-7625

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	08/22/2020

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