Provider Demographics
NPI:1932297546
Name:NEXT LEVEL PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:NEXT LEVEL PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DANE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT MPT MTC PHYSICAL
Authorized Official - Phone:303-279-6000
Mailing Address - Street 1:221 CORPORATE CIRCLE
Mailing Address - Street 2:SUITE J
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401
Mailing Address - Country:US
Mailing Address - Phone:303-279-6000
Mailing Address - Fax:303-279-7799
Practice Address - Street 1:221 CORPORATE CIRCLE
Practice Address - Street 2:SUITE J
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401
Practice Address - Country:US
Practice Address - Phone:303-279-6000
Practice Address - Fax:303-279-7799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7991225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C803352Medicare ID - Type Unspecified