Provider Demographics
NPI:1720770233
Name:LANG, CASSIDY PAIGE (DPT)
Entity Type:Individual
Prefix:
First Name:CASSIDY
Middle Name:PAIGE
Last Name:LANG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15000 W 6TH AVE UNIT 106-B
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-6586
Mailing Address - Country:US
Mailing Address - Phone:720-541-6817
Mailing Address - Fax:720-541-6818
Practice Address - Street 1:15000 W 6TH AVE UNIT 106-B
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-6586
Practice Address - Country:US
Practice Address - Phone:720-541-6817
Practice Address - Fax:720-541-6818
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19123225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist