Provider Demographics
NPI:1407471386
Name:WIMER, VICTORIA ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANN
Last Name:WIMER
Suffix:
Gender:F
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 1:7878 WADSWORTH BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-2121
Mailing Address - Country:US
Mailing Address - Phone:303-456-8967
Mailing Address - Fax:
Practice Address - Street 1:7878 WADSWORTH BLVD STE 210
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2121
Practice Address - Country:US
Practice Address - Phone:303-456-8967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0016959225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist