Provider Demographics
NPI:1326473141
Name:MVP PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:MVP PHYSICAL THERAPY, LLC
Other - Org Name:MVP PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:SHANE
Authorized Official - Last Name:ESKEW
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:303-332-1761
Mailing Address - Street 1:13635 E 104TH AVE
Mailing Address - Street 2:STE 700
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-8409
Mailing Address - Country:US
Mailing Address - Phone:720-506-5340
Mailing Address - Fax:
Practice Address - Street 1:13659 E 104TH AVE UNIT 300
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-9402
Practice Address - Country:US
Practice Address - Phone:720-506-5340
Practice Address - Fax:720-506-5343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-11
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10125225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty