Provider Demographics
NPI:1063514255
Name:WEBB, NICOLE MARIE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:MARIE
Last Name:WEBB
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
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Mailing Address - Street 1:3401 QUEBEC ST
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-2322
Mailing Address - Country:US
Mailing Address - Phone:303-333-3493
Mailing Address - Fax:303-388-8990
Practice Address - Street 1:3401 QUEBEC ST
Practice Address - Street 2:SUITE 3100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-2322
Practice Address - Country:US
Practice Address - Phone:303-333-3493
Practice Address - Fax:303-388-8990
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO7330225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC805946Medicare PIN