Provider Demographics
NPI:1639371404
Name:VISLOSKY, DAVID A (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:VISLOSKY
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-9202
Mailing Address - Country:US
Mailing Address - Phone:303-420-1998
Mailing Address - Fax:303-420-1650
Practice Address - Street 1:9101 HARLAN ST UNIT 225
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-2926
Practice Address - Country:US
Practice Address - Phone:303-420-1998
Practice Address - Fax:303-420-1650
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist