Provider Demographics
NPI:1104531672
Name:TOAL, CHARLES REAGAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:REAGAN
Last Name:TOAL
Suffix:
Gender:M
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 1:730 14TH ST SW STE 200
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-6349
Mailing Address - Country:US
Mailing Address - Phone:970-663-0815
Mailing Address - Fax:
Practice Address - Street 1:730 14TH ST SW STE 200
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-6349
Practice Address - Country:US
Practice Address - Phone:970-663-0815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-19
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0020907225100000X
WAPT61675054225100000X
CA305820225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist