Provider Demographics
NPI:1265903041
Name:MILHOMENS VILASBOAS, PATRICIA (PT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MILHOMENS VILASBOAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13606 XAVIER LN STE C
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-3604
Mailing Address - Country:US
Mailing Address - Phone:303-404-9494
Mailing Address - Fax:303-404-2252
Practice Address - Street 1:13606 XAVIER LN STE C
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-3604
Practice Address - Country:US
Practice Address - Phone:303-404-9494
Practice Address - Fax:303-404-2252
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT0022166225700000X
CO20105225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist