Provider Demographics
NPI:1316402654
Name:LANHAM, JOSHUA JACOB
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JACOB
Last Name:LANHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8968 FOX DR UNIT 103
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80260-8826
Mailing Address - Country:US
Mailing Address - Phone:720-810-2485
Mailing Address - Fax:
Practice Address - Street 1:890 AURARIA PKWY # 310
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1806
Practice Address - Country:US
Practice Address - Phone:303-556-5740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer