Provider Demographics
NPI:1538161021
Name:THERAPY DYNAMICS
Entity type:Organization
Organization Name:THERAPY DYNAMICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICAL THERAPY
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RABER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:303-650-6616
Mailing Address - Street 1:5005 W 81ST PL
Mailing Address - Street 2:#100
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-7025
Mailing Address - Country:US
Mailing Address - Phone:303-650-6616
Mailing Address - Fax:303-650-0718
Practice Address - Street 1:5005 W 81ST PL
Practice Address - Street 2:#100
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-7025
Practice Address - Country:US
Practice Address - Phone:303-650-6616
Practice Address - Fax:303-650-0718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO1190225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO376608Medicare ID - Type Unspecified