Provider Demographics
NPI:1861490112
Name:MCAWARD, JOHN M JR (PT, MTC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:M
Last Name:MCAWARD
Suffix:JR
Gender:M
Credentials:PT, MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 800022
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-0022
Mailing Address - Country:US
Mailing Address - Phone:800-953-0104
Mailing Address - Fax:303-765-6670
Practice Address - Street 1:1 MERCADO ST STE 201
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7307
Practice Address - Country:US
Practice Address - Phone:970-385-0644
Practice Address - Fax:970-385-0620
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0002702225100000X
CO27022251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO54804337Medicaid
NM63722887Medicaid