Provider Demographics
NPI:1649614603
Name:SHYU, KUANG-YEN (PT, DPT, CSCS, CSPS)
Entity type:Individual
Prefix:
First Name:KUANG-YEN
Middle Name:
Last Name:SHYU
Suffix:
Gender:M
Credentials:PT, DPT, CSCS, CSPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9499 WASHINGTON ST UNIT 100
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-3588
Mailing Address - Country:US
Mailing Address - Phone:720-443-3033
Mailing Address - Fax:
Practice Address - Street 1:9499 WASHINGTON ST UNIT 100
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-3588
Practice Address - Country:US
Practice Address - Phone:720-443-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0016878225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist