Provider Demographics
NPI:1376183103
Name:EATON, RICHARD JR (MSPT)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:EATON
Suffix:JR
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19033 E PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-9044
Mailing Address - Country:US
Mailing Address - Phone:303-805-4497
Mailing Address - Fax:303-805-3937
Practice Address - Street 1:19033 E PLAZA DR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9044
Practice Address - Country:US
Practice Address - Phone:303-805-4497
Practice Address - Fax:303-805-3937
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006971225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist