Provider Demographics
NPI:1700397841
Name:REMINGTON, NICOLE M (DPT)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:M
Last Name:REMINGTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16056 SEQUOIA DR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3547
Mailing Address - Country:US
Mailing Address - Phone:925-321-3369
Mailing Address - Fax:
Practice Address - Street 1:19284 COTTONWOOD DR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-3882
Practice Address - Country:US
Practice Address - Phone:720-777-1303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39302225100000X
COPTL.0015160225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist