Provider Demographics
NPI:1427234251
Name:WODICKA, JAMES ALAN (DPT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ALAN
Last Name:WODICKA
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 1:9116 W BOWLES AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-3477
Mailing Address - Country:US
Mailing Address - Phone:303-978-9200
Mailing Address - Fax:303-973-4886
Practice Address - Street 1:9116 W BOWLES AVE STE 10
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-3477
Practice Address - Country:US
Practice Address - Phone:303-978-9200
Practice Address - Fax:303-973-4886
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9762225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist