Provider Demographics
NPI:1972221547
Name:BOLES, ROWAN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ROWAN
Middle Name:
Last Name:BOLES
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 E CHERRY CREEK SOUTH DR APT J102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-7847
Mailing Address - Country:US
Mailing Address - Phone:720-427-0247
Mailing Address - Fax:
Practice Address - Street 1:400 S COLORADO BLVD STE 640
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1239
Practice Address - Country:US
Practice Address - Phone:303-320-4450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0017223225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist