Provider Demographics
NPI:1356567960
Name:NGUYEN, ANGIE T (PT,)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PT,
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:12211W ALAMEDA PKWY 104
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2825
Mailing Address - Country:US
Mailing Address - Phone:720-519-1548
Mailing Address - Fax:720-519-1698
Practice Address - Street 1:9195 GRANT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4386
Practice Address - Country:US
Practice Address - Phone:303-451-7700
Practice Address - Fax:303-252-9474
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2015-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO8733225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO066615OtherMEDICARE GROUP PTAN