Provider Demographics
NPI:1932388055
Name:PARKER PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:PARKER PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:303-841-7737
Mailing Address - Street 1:12840 STROH RANCH CT
Mailing Address - Street 2:UNIT 103
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7701
Mailing Address - Country:US
Mailing Address - Phone:303-841-7737
Mailing Address - Fax:303-840-1777
Practice Address - Street 1:12840 STROH RANCH CT
Practice Address - Street 2:UNIT 103
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7701
Practice Address - Country:US
Practice Address - Phone:303-841-7737
Practice Address - Fax:303-840-1777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8522261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC811633Medicare PIN