Provider Demographics
NPI:1952595647
Name:INTEGRATED PHYSICAL THERAPY OF COLORADO PC
Entity Type:Organization
Organization Name:INTEGRATED PHYSICAL THERAPY OF COLORADO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:HAY
Authorized Official - Last Name:BUXTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-904-8133
Mailing Address - Street 1:9200 W CROSS DR STE 520
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-0761
Mailing Address - Country:US
Mailing Address - Phone:303-904-8133
Mailing Address - Fax:303-904-8109
Practice Address - Street 1:9200 W CROSS DR STE 520
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-0761
Practice Address - Country:US
Practice Address - Phone:303-904-8133
Practice Address - Fax:303-904-8109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC458228Medicare PIN