Provider Demographics
NPI:1952184285
Name:FAILLA, SYDNEY ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:ANN
Last Name:FAILLA
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 1:13593 VIA VARRA UNIT 1323
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-9515
Mailing Address - Country:US
Mailing Address - Phone:904-472-8169
Mailing Address - Fax:
Practice Address - Street 1:7878 WADSWORTH BLVD STE 210
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2121
Practice Address - Country:US
Practice Address - Phone:303-456-8967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0019330225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist