MEDICARE: SOUTH VALLEY PHYSICAL THERAPY 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1528137734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH VALLEY PHYSICAL THERAPY PC

Provider Business Mailing Address
First Line	:	495 UINTA WAY STE 100
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80230-7198
Country	:	US
Telephone Number	:	303-861-0057
Fax Number	:	303-831-0152

Provider Business Practice Location Address
First Line	:	495 UINTA WAY STE 100
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80230-7198
Country	:	US
Telephone Number	:	303-861-0057
Fax Number	:	303-831-0152

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SARAH BOSLEY GALLAGHER
Credential	:
Telephone Number	:	303-909-5326

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	10/17/2023

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