Provider Demographics
NPI:1124103155
Name:FELDHAKE PHYSICAL THERAPY, LTD.
Entity type:Organization
Organization Name:FELDHAKE PHYSICAL THERAPY, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FELDHAKE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:720-493-1181
Mailing Address - Street 1:7340 S ALTON WAY STE 11-D
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2323
Mailing Address - Country:US
Mailing Address - Phone:720-493-1181
Mailing Address - Fax:720-493-1191
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO74512251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO800550Medicare PIN