Provider Demographics
NPI:1477831394
Name:NISHIMOTO AND NEUJAHR PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:NISHIMOTO AND NEUJAHR PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:NISHIMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:720-402-3801
Mailing Address - Street 1:1601 E 19TH AVE
Mailing Address - Street 2:SUITE 5500
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1216
Mailing Address - Country:US
Mailing Address - Phone:720-402-3801
Mailing Address - Fax:720-402-3820
Practice Address - Street 1:1601 E 19TH AVE
Practice Address - Street 2:5500
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1216
Practice Address - Country:US
Practice Address - Phone:720-402-3801
Practice Address - Fax:720-402-3820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10741261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO10741OtherCOLORADO STATE LICENSE