Provider Demographics
NPI:1891559639
Name:ANSCHUTZ, CODY DON (PT, DPT, ATC)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:DON
Last Name:ANSCHUTZ
Suffix:
Gender:M
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6840 S UNIVERSITY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-1510
Mailing Address - Country:US
Mailing Address - Phone:303-771-5120
Mailing Address - Fax:
Practice Address - Street 1:6840 S UNIVERSITY BLVD STE 400
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-1510
Practice Address - Country:US
Practice Address - Phone:303-771-5120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAT.00026592255A2300X
COPTL.0019608225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer