Provider Demographics
NPI:1225625171
Name:PALMER, ANDREW THOMAS (PT, DPT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:THOMAS
Last Name:PALMER
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 1:1455 MAIN ST STE 160
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-5561
Mailing Address - Country:US
Mailing Address - Phone:970-674-6514
Mailing Address - Fax:970-674-6598
Practice Address - Street 1:1455 MAIN ST STE 160
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-5561
Practice Address - Country:US
Practice Address - Phone:970-674-6514
Practice Address - Fax:970-674-6598
Is Sole Proprietor?:No
Enumeration Date:2020-12-27
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12325024225100000X
COPTL.0019832225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist