Provider Demographics
NPI:1295939841
Name:CHUBBS, RICHARD (PTA)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:CHUBBS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3070 HARVEST CIR
Mailing Address - Street 2:
Mailing Address - City:DACONO
Mailing Address - State:CO
Mailing Address - Zip Code:80514-8515
Mailing Address - Country:US
Mailing Address - Phone:303-833-9240
Mailing Address - Fax:303-833-9240
Practice Address - Street 1:2121 MESA DR
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3621
Practice Address - Country:US
Practice Address - Phone:720-565-2693
Practice Address - Fax:720-565-2693
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT-5351225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant