Provider Demographics
NPI:1952336695
Name:BENNETT, JOYCE R (PT/ CHT)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:R
Last Name:BENNETT
Suffix:
Gender:F
Credentials:PT/ CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10359 NORTH FEDERAL BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80260
Mailing Address - Country:US
Mailing Address - Phone:303-410-8178
Mailing Address - Fax:303-410-2573
Practice Address - Street 1:10359 NORTH FEDERAL BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80260
Practice Address - Country:US
Practice Address - Phone:303-410-8178
Practice Address - Fax:303-410-2573
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1251225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO94589801Medicaid
CO1C25873Medicare PIN
CO94589801Medicaid
CO808768Medicare PIN