Provider Demographics
NPI:1649871070
Name:COZAD, HALEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:COZAD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14085 DENVER WEST CIR APT 2305
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3329
Mailing Address - Country:US
Mailing Address - Phone:412-518-2047
Mailing Address - Fax:
Practice Address - Street 1:1700 E 17TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1668
Practice Address - Country:US
Practice Address - Phone:303-932-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0016963225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist