Provider Demographics
NPI:1114585924
Name:BUI, ANH T (PT, DPT, CSCS)
Entity Type:Individual
Prefix:
First Name:ANH
Middle Name:T
Last Name:BUI
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17585 PINE LN APT 5406
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-6555
Mailing Address - Country:US
Mailing Address - Phone:510-688-0485
Mailing Address - Fax:
Practice Address - Street 1:3550 FRONTIER AVE STE D
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2430
Practice Address - Country:US
Practice Address - Phone:720-504-5835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0016413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist