Provider Demographics
NPI:1184634776
Name:JAMES, DAVID A (MSPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:JAMES
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:2861 W 120TH AVE
Practice Address - Street 2:STE 120
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2987
Practice Address - Country:US
Practice Address - Phone:303-469-6980
Practice Address - Fax:303-469-6984
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7633225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
102255331OtherOWCP FACILITY ID
CO06-6600Medicare Oscar/Certification