Provider Demographics
NPI:1972925006
Name:ATLAS PHYSICAL THERAPY AT STAPLETON, PLLC
Entity type:Organization
Organization Name:ATLAS PHYSICAL THERAPY AT STAPLETON, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:LANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-322-4900
Mailing Address - Street 1:3401 QUEBEC ST
Mailing Address - Street 2:5005
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-2322
Mailing Address - Country:US
Mailing Address - Phone:303-322-4900
Mailing Address - Fax:303-322-4909
Practice Address - Street 1:3401 QUEBEC ST
Practice Address - Street 2:5005
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-2322
Practice Address - Country:US
Practice Address - Phone:303-322-4900
Practice Address - Fax:303-322-4909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10679261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1922258953Medicare Oscar/Certification