Provider Demographics
NPI:1891078622
Name:GROSETH, HOLLY NICOLE (DPT)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:NICOLE
Last Name:GROSETH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:HUMPHREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2172 S TRENTON WAY
Mailing Address - Street 2:#3-202
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5379
Mailing Address - Country:US
Mailing Address - Phone:909-223-2398
Mailing Address - Fax:
Practice Address - Street 1:2172 S TRENTON WAY
Practice Address - Street 2:#3-202
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5379
Practice Address - Country:US
Practice Address - Phone:909-223-2398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT26820225100000X
COPTL.0012441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist