Provider Demographics
NPI:1114174109
Name:MILE HIGH PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:MILE HIGH PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PADEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-856-3299
Mailing Address - Street 1:495 UINTA WAY STE 110
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7198
Mailing Address - Country:US
Mailing Address - Phone:303-856-3299
Mailing Address - Fax:303-856-7787
Practice Address - Street 1:495 UINTA WAY STE 110
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7198
Practice Address - Country:US
Practice Address - Phone:303-856-3299
Practice Address - Fax:303-856-7787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6156174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCF6803Medicare PIN