Provider Demographics
NPI:1255688529
Name:MAKALA, WOYTEK (PT, DPT)
Entity Type:Individual
Prefix:
First Name:WOYTEK
Middle Name:
Last Name:MAKALA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 E 1ST AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2401
Mailing Address - Country:US
Mailing Address - Phone:303-460-0329
Mailing Address - Fax:303-460-0387
Practice Address - Street 1:340 E 1ST AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2401
Practice Address - Country:US
Practice Address - Phone:303-460-0329
Practice Address - Fax:303-460-0387
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO117472251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic