Provider Demographics
NPI:1699321695
Name:SOLAWA, ARKADIUSZ ANDRZEJ (DPT)
Entity type:Individual
Prefix:
First Name:ARKADIUSZ
Middle Name:ANDRZEJ
Last Name:SOLAWA
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 1:12607 ZUNI ST APT 206
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-3822
Mailing Address - Country:US
Mailing Address - Phone:847-529-1821
Mailing Address - Fax:
Practice Address - Street 1:400 S COLORADO BLVD STE 640
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246-1239
Practice Address - Country:US
Practice Address - Phone:303-320-4450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0016501225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist