Provider Demographics
NPI:1306689914
Name:SUMNICHT, ANAIS (PTA)
Entity type:Individual
Prefix:
First Name:ANAIS
Middle Name:
Last Name:SUMNICHT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14211 E 4TH AVE STE 3-135
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8736
Mailing Address - Country:US
Mailing Address - Phone:303-995-5812
Mailing Address - Fax:
Practice Address - Street 1:14211 E 4TH AVE STE 3-135
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8736
Practice Address - Country:US
Practice Address - Phone:303-995-5812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTA0014197225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant