Provider Demographics
NPI:1497943278
Name:SZYMANSKI, PETER STANLEY (PT)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:STANLEY
Last Name:SZYMANSKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 RALEIGH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-1374
Mailing Address - Country:US
Mailing Address - Phone:303-458-9660
Mailing Address - Fax:303-458-9661
Practice Address - Street 1:1525 RALEIGH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1374
Practice Address - Country:US
Practice Address - Phone:303-458-9660
Practice Address - Fax:303-458-9661
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC801082Medicare PIN