Provider Demographics
NPI:1265550313
Name:FOOTHILLS PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:FOOTHILLS PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:303-761-3085
Mailing Address - Street 1:901 ENGLEWOOD PKWY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-2305
Mailing Address - Country:US
Mailing Address - Phone:303-761-3085
Mailing Address - Fax:303-761-4066
Practice Address - Street 1:901 ENGLEWOOD PKWY
Practice Address - Street 2:SUITE 108
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-2305
Practice Address - Country:US
Practice Address - Phone:303-761-3085
Practice Address - Fax:303-761-4066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44892251S0007X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty