MEDICARE: ALAN M MAZUR PT

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	070015953	IL
2	225100000X	Physical Therapist	PTL.0012141	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PTL.0012141	OTHER	CO	PHYSICAL THERAPY LICENSE

General Provider Information

NPI Number	:	1669666582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN M MAZUR PT

Provider Business Mailing Address
First Line	:	1385 S COLORADO BLVD # A-620
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-3304
Country	:	US
Telephone Number	:	303-691-3733
Fax Number	:	303-691-1142

Provider Business Practice Location Address
First Line	:	1385 S COLORADO BLVD # A-620
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-3304
Country	:	US
Telephone Number	:	303-691-3733
Fax Number	:	303-680-8627

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

Provider Enumeration Date	:	09/04/2007
Last Update Date	:	07/25/2018

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Directions to “ ALAN M MAZUR PT” Practice Location

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