Provider Demographics
NPI:1457927006
Name:ZWEBER, STANLEY JAMES (LMT)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:JAMES
Last Name:ZWEBER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4689 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2262
Mailing Address - Country:US
Mailing Address - Phone:720-849-3607
Mailing Address - Fax:
Practice Address - Street 1:1800 30TH ST STE 308
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1026
Practice Address - Country:US
Practice Address - Phone:720-849-3607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001026225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist