Provider Demographics
NPI:1891501771
Name:ARCHULETA, CARLOS (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:ARCHULETA
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 1:2175 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-3238
Mailing Address - Country:US
Mailing Address - Phone:970-593-9300
Mailing Address - Fax:
Practice Address - Street 1:2175 E 11TH ST
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3238
Practice Address - Country:US
Practice Address - Phone:970-593-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0020233225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist