Provider Demographics
NPI:1164505541
Name:ARAPAHOE PEAK PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:ARAPAHOE PEAK PHYSICAL THERAPY, LLC
Other - Org Name:BERGEN PARK PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:D
Authorized Official - Last Name:SAVALA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:303-674-5522
Mailing Address - Street 1:3649 EVERGREEN PKWY UNIT 2107
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80437-2107
Mailing Address - Country:US
Mailing Address - Phone:303-674-5522
Mailing Address - Fax:720-306-3512
Practice Address - Street 1:32003 ELLINGWOOD TRL
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439
Practice Address - Country:US
Practice Address - Phone:303-674-5522
Practice Address - Fax:720-306-3512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-22
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6621225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO802339Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION N