Provider Demographics
NPI:1922337823
Name:STONEBERGER, CASEY (DPT)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:STONEBERGER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8510 BRYANT ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3844
Mailing Address - Country:US
Mailing Address - Phone:720-497-6666
Mailing Address - Fax:720-497-6777
Practice Address - Street 1:8510 BRYANT ST
Practice Address - Street 2:SUITE 130
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3844
Practice Address - Country:US
Practice Address - Phone:720-497-6666
Practice Address - Fax:720-497-6777
Is Sole Proprietor?:No
Enumeration Date:2009-12-24
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10646225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO307157Medicare PIN