Provider Demographics
NPI:1669850533
Name:MANN METHOD PHYSICAL THERAPY AND FITNESS, PLLC
Entity Type:Organization
Organization Name:MANN METHOD PHYSICAL THERAPY AND FITNESS, PLLC
Other - Org Name:MANN METHOD PHYSICAL THERAPY AND FITNESS, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:RE
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:303-709-6381
Mailing Address - Street 1:20074 W 94TH LN
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-7718
Mailing Address - Country:US
Mailing Address - Phone:303-709-6381
Mailing Address - Fax:303-256-0572
Practice Address - Street 1:13825 W. 85TH DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-5950
Practice Address - Country:US
Practice Address - Phone:720-524-4659
Practice Address - Fax:303-256-0572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011874261QP2000X, 261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO83455388Medicaid
CO501438OtherMEDICARE PTAN
CO501438OtherMEDICARE PTAN