Provider Demographics
NPI:1114603065
Name:RACASAN, ELSA IOANA (DPT)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:IOANA
Last Name:RACASAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 E ARIZONA AVE APT 1345
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210
Mailing Address - Country:US
Mailing Address - Phone:832-986-2235
Mailing Address - Fax:
Practice Address - Street 1:9139 RIDGELINE BLVD SUITE 100
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129
Practice Address - Country:US
Practice Address - Phone:720-777-9015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0019185225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist