Provider Demographics
NPI:1548469984
Name:WALFORD, ROBERT CARL
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CARL
Last Name:WALFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13918 E MISSISSIPPI AVE
Mailing Address - Street 2:337
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3603
Mailing Address - Country:US
Mailing Address - Phone:702-400-6916
Mailing Address - Fax:
Practice Address - Street 1:8227 S. HOLLY ST.
Practice Address - Street 2:PREMIER CARE PHYSICAL THERAPY
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122
Practice Address - Country:US
Practice Address - Phone:303-770-0250
Practice Address - Fax:303-770-0320
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4677111N00000X
CO5729225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No111N00000XChiropractic ProvidersChiropractor