Provider Demographics
NPI:1770506693
Name:ANYWHERE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ANYWHERE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MANDSAGER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:970-391-2262
Mailing Address - Street 1:PO BOX 2593
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80539-2593
Mailing Address - Country:US
Mailing Address - Phone:970-391-2262
Mailing Address - Fax:970-669-7262
Practice Address - Street 1:4492 FOOTHILLS DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3567
Practice Address - Country:US
Practice Address - Phone:970-391-2262
Practice Address - Fax:970-669-7262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7286225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO552898Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER