Provider Demographics
NPI:1811959521
Name:RENDLE, LANCE W (PT)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:W
Last Name:RENDLE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1649 S CLAYTON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2820
Mailing Address - Country:US
Mailing Address - Phone:970-946-3591
Mailing Address - Fax:
Practice Address - Street 1:7390 W EASTMAN PL
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5039
Practice Address - Country:US
Practice Address - Phone:303-998-2848
Practice Address - Fax:720-623-4464
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5342225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist