Provider Demographics
NPI:1992070478
Name:ELMQUIST, JOSHUA RYAN (DPT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:RYAN
Last Name:ELMQUIST
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 1:400 INDIANA ST 320
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5033
Mailing Address - Country:US
Mailing Address - Phone:303-469-3182
Mailing Address - Fax:
Practice Address - Street 1:400 INDIANA ST
Practice Address - Street 2:SUITE 320
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5027
Practice Address - Country:US
Practice Address - Phone:509-979-2997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2015-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist