Provider Demographics
NPI:1083291660
Name:NORBERTO, THOMAS RUECK (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:RUECK
Last Name:NORBERTO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13659 E 104TH AVE UNIT 300
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-9402
Mailing Address - Country:US
Mailing Address - Phone:720-506-5340
Mailing Address - Fax:720-506-5343
Practice Address - Street 1:13659 E 104TH AVE UNIT 300
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-9402
Practice Address - Country:US
Practice Address - Phone:720-506-5340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28681225100000X
VT040.0134259225100000X
WI15370225100000X
COPTL.0018567225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist