Provider Demographics
NPI:1124103148
Name:FELDHAKE, WILLIAM JAMES (PT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JAMES
Last Name:FELDHAKE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 S PEARL ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2645
Mailing Address - Country:US
Mailing Address - Phone:303-778-7246
Mailing Address - Fax:303-871-0830
Practice Address - Street 1:1550 S PEARL ST
Practice Address - Street 2:SUITE 101
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-2645
Practice Address - Country:US
Practice Address - Phone:303-778-7246
Practice Address - Fax:303-871-0830
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO74512251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1668869OtherCIGNA
CO656953OtherBLUE CROSS BLUE SHIELD
CO800551Medicare PIN