Provider Demographics
NPI:1316535891
Name:USUI, TOMOKI KEN (DPT)
Entity Type:Individual
Prefix:
First Name:TOMOKI
Middle Name:KEN
Last Name:USUI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16321 GRAHAM PEAK WAY
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-8326
Mailing Address - Country:US
Mailing Address - Phone:720-548-0068
Mailing Address - Fax:
Practice Address - Street 1:1325 DRY CREEK DR STE 307
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-7751
Practice Address - Country:US
Practice Address - Phone:720-548-0068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-09
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0017374225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist