Provider Demographics
NPI:1801827050
Name:FAMILY NET PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:FAMILY NET PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRONNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:720-314-5878
Mailing Address - Street 1:PO BOX 261190
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80163-1190
Mailing Address - Country:US
Mailing Address - Phone:720-314-5878
Mailing Address - Fax:303-806-8802
Practice Address - Street 1:5730 WARD RD STE 102
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1300
Practice Address - Country:US
Practice Address - Phone:303-422-6331
Practice Address - Fax:303-422-6379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4845225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCR3803Medicare ID - Type Unspecified