Provider Demographics
NPI:1235218322
Name:NOEL, PATRICIA LOU (PT, SCD)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LOU
Last Name:NOEL
Suffix:
Gender:F
Credentials:PT, SCD
Other - Prefix:DR
Other - First Name:PATTY
Other - Middle Name:L
Other - Last Name:PENNELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT SCD
Mailing Address - Street 1:1601 S LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2603
Mailing Address - Country:US
Mailing Address - Phone:303-478-2085
Mailing Address - Fax:303-996-0390
Practice Address - Street 1:600 N GRANT ST STE 208
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3527
Practice Address - Country:US
Practice Address - Phone:303-832-5577
Practice Address - Fax:303-996-0390
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4054225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC476398Medicare ID - Type UnspecifiedMEDICARE GROUP