Provider Demographics
NPI:1730139841
Name:KERTZER, JOEL D (PT)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:D
Last Name:KERTZER
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:6979 S HOLLY CIR
Mailing Address - Street 2:STE 105
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1577
Mailing Address - Country:US
Mailing Address - Phone:303-694-2295
Mailing Address - Fax:303-694-1843
Practice Address - Street 1:9351 GRANT ST
Practice Address - Street 2:STE 430
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4358
Practice Address - Country:US
Practice Address - Phone:303-280-1211
Practice Address - Fax:303-280-2232
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO2963225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO805021Medicare PIN
CO805017Medicare PIN
CO066600Medicare Oscar/Certification