Provider Demographics
NPI:1154470698
Name:WOLFE, PADEN (DPT)
Entity type:Individual
Prefix:
First Name:PADEN
Middle Name:
Last Name:WOLFE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 UINTA WAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7110
Mailing Address - Country:US
Mailing Address - Phone:303-856-3299
Mailing Address - Fax:303-856-7787
Practice Address - Street 1:495 UINTA WAY
Practice Address - Street 2:SUITE 110
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7110
Practice Address - Country:US
Practice Address - Phone:303-856-3299
Practice Address - Fax:303-856-7787
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6156174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist