Provider Demographics
NPI:1255094991
Name:WARNER, ANTHONY (PTA)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:WARNER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 W CRESTLINE AVE APT 426
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-1290
Mailing Address - Country:US
Mailing Address - Phone:314-482-6614
Mailing Address - Fax:
Practice Address - Street 1:2260 S XANADU WAY STE 245
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-6558
Practice Address - Country:US
Practice Address - Phone:303-755-8826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTA.0014852225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant