Provider Demographics
NPI:1063820272
Name:ECCLES, DAREN (DPT)
Entity Type:Individual
Prefix:
First Name:DAREN
Middle Name:
Last Name:ECCLES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5820 CLARET ST
Mailing Address - Street 2:
Mailing Address - City:TIMNATH
Mailing Address - State:CO
Mailing Address - Zip Code:80547-2524
Mailing Address - Country:US
Mailing Address - Phone:845-380-6408
Mailing Address - Fax:772-221-3373
Practice Address - Street 1:1566 VISTA VIEW DR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-5278
Practice Address - Country:US
Practice Address - Phone:720-266-7100
Practice Address - Fax:772-221-3373
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL00153192251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic