Provider Demographics
NPI:1720724180
Name:BOSHEARS, ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:BOSHEARS
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 1:11416 W 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-3802
Mailing Address - Country:US
Mailing Address - Phone:971-506-3900
Mailing Address - Fax:
Practice Address - Street 1:4350 WADSWORTH BLVD STE 425
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4652
Practice Address - Country:US
Practice Address - Phone:303-564-1246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0017020225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist