Provider Demographics
NPI:1104904713
Name:SUN, BETH ANN (PHYICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:SUN
Suffix:
Gender:F
Credentials:PHYICAL THERAPIST
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 POTOMAC ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-6716
Mailing Address - Country:US
Mailing Address - Phone:303-363-5150
Mailing Address - Fax:303-363-5201
Practice Address - Street 1:16799 E LAKE AVE
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80016-3079
Practice Address - Country:US
Practice Address - Phone:720-845-1976
Practice Address - Fax:720-845-1958
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK832174400000X
COPTL00106752251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK151390Medicare ID - Type Unspecified