Provider Demographics
NPI:1548069479
Name:LAREAU, ANTHONY WILLIAM (PT, DPT)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:WILLIAM
Last Name:LAREAU
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 1:3490 HAYDEN PL APT 3
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1932
Mailing Address - Country:US
Mailing Address - Phone:608-225-8454
Mailing Address - Fax:
Practice Address - Street 1:4550 MAIN ST UNIT 200
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-5175
Practice Address - Country:US
Practice Address - Phone:720-497-6162
Practice Address - Fax:720-497-6723
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0020410225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist