Provider Demographics
NPI:1184835431
Name:HENDRICKSON, ADRIA JUNE (PT)
Entity Type:Individual
Prefix:
First Name:ADRIA
Middle Name:JUNE
Last Name:HENDRICKSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10475 DALE CIR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-3532
Mailing Address - Country:US
Mailing Address - Phone:585-377-2534
Mailing Address - Fax:
Practice Address - Street 1:400 S COLORADO BLVD
Practice Address - Street 2:SUITE NUMBER 640
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1253
Practice Address - Country:US
Practice Address - Phone:303-320-4450
Practice Address - Fax:303-320-6668
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8098225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist