Provider Demographics
NPI:1073822599
Name:PHYSICAL DIMENSIONS PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:PHYSICAL DIMENSIONS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:CORBIN
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-925-1050
Mailing Address - Street 1:9068 FORSSTROM DR UNIT C25
Mailing Address - Street 2:
Mailing Address - City:LONETREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5578
Mailing Address - Country:US
Mailing Address - Phone:303-925-1050
Mailing Address - Fax:
Practice Address - Street 1:9068 FORSSTROM DR UNIT C25
Practice Address - Street 2:
Practice Address - City:LONETREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5578
Practice Address - Country:US
Practice Address - Phone:303-925-1050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty