Provider Demographics
NPI:1629084801
Name:FOX, ZACHARY G (PT, DPT, ATC)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:G
Last Name:FOX
Suffix:
Gender:M
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9218 KIMMER DR
Mailing Address - Street 2:STE 100
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-6733
Mailing Address - Country:US
Mailing Address - Phone:303-792-7377
Mailing Address - Fax:
Practice Address - Street 1:12311 PINE BLUFFS WAY
Practice Address - Street 2:UNIT J
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4339
Practice Address - Country:US
Practice Address - Phone:720-851-6695
Practice Address - Fax:720-851-4994
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012205225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPENDINGMedicare PIN