Provider Demographics
NPI:1073546446
Name:NORTHMETRO PHYSICAL THERAPY AND WELLNESS PC
Entity Type:Organization
Organization Name:NORTHMETRO PHYSICAL THERAPY AND WELLNESS PC
Other - Org Name:IN HOME REHAB -- NORTHMETRO DENVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MILANI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:720-982-3783
Mailing Address - Street 1:1160 E 130TH AVE
Mailing Address - Street 2:UNIT B
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3933
Mailing Address - Country:US
Mailing Address - Phone:720-982-3783
Mailing Address - Fax:303-452-3087
Practice Address - Street 1:2350 LIMON DR
Practice Address - Street 2:SUITE 258
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-7643
Practice Address - Country:US
Practice Address - Phone:970-213-9579
Practice Address - Fax:970-282-1892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7772225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC805757Medicare PIN
CO805757Medicare PIN