Provider Demographics
NPI:1215636774
Name:THOMSEN, PETER BENSON (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:BENSON
Last Name:THOMSEN
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 1:5400 W 97TH AVE APT 2105
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80020-5718
Mailing Address - Country:US
Mailing Address - Phone:630-414-7968
Mailing Address - Fax:
Practice Address - Street 1:5801 S QUEBEC ST STE 100
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2010
Practice Address - Country:US
Practice Address - Phone:720-407-8978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0018975225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist