Provider Demographics
NPI:1790889343
Name:CORBO, CHRISTOPHER JEFFREY (LPT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JEFFREY
Last Name:CORBO
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19438 W 52ND DR
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403
Mailing Address - Country:US
Mailing Address - Phone:813-495-1251
Mailing Address - Fax:
Practice Address - Street 1:19438 W 52ND DR
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-2171
Practice Address - Country:US
Practice Address - Phone:813-495-1251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT150562251C2600X
COPTL.00145812251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonary
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3349Medicare ID - Type UnspecifiedMEDICARE #