Provider Demographics
NPI:1407884158
Name:THERAPHYSICS PARTNERS OF COLORADO, INC.
Entity Type:Organization
Organization Name:THERAPHYSICS PARTNERS OF COLORADO, INC.
Other - Org Name:NORTHWEST PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:TARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-972-1100
Mailing Address - Street 1:4714 GETTYSBURG RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4325
Mailing Address - Country:US
Mailing Address - Phone:717-972-1100
Mailing Address - Fax:
Practice Address - Street 1:7878 WADSWORTH BLVD
Practice Address - Street 2:SUITE 210
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:303-456-8972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2018-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO066515Medicare Oscar/Certification