Provider Demographics
NPI:1093481681
Name:DITSWORTH, COLIN STERLING (DPT)
Entity Type:Individual
Prefix:
First Name:COLIN
Middle Name:STERLING
Last Name:DITSWORTH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 S KIPLING PKWY STE A4
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-1375
Mailing Address - Country:US
Mailing Address - Phone:303-274-7331
Mailing Address - Fax:720-497-6726
Practice Address - Street 1:5005 S KIPLING PKWY STE A4
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-1375
Practice Address - Country:US
Practice Address - Phone:303-274-7331
Practice Address - Fax:720-497-6726
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4653225100000X
CO18312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist