Provider Demographics
NPI:1548992985
Name:STROCK, CHRISTIAN DAVID (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:DAVID
Last Name:STROCK
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 1:10452 GARLAND WAY
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3641
Mailing Address - Country:US
Mailing Address - Phone:321-576-6279
Mailing Address - Fax:
Practice Address - Street 1:9101 PEARL ST STE 350
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4390
Practice Address - Country:US
Practice Address - Phone:720-328-1246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225100000X
CO0018704225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist