Provider Demographics
NPI:1861626509
Name:HALLAHAN, NATHANIEL O'BRIEN (PT)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:O'BRIEN
Last Name:HALLAHAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 S ROUTT ST STE 300
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2354
Mailing Address - Country:US
Mailing Address - Phone:720-321-8920
Mailing Address - Fax:
Practice Address - Street 1:255 S ROUTT ST STE 300
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2354
Practice Address - Country:US
Practice Address - Phone:720-321-8920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-10
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9871225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist