Provider Demographics
NPI:1730848623
Name:MERTZ, PATRICK HACKMANN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:HACKMANN
Last Name:MERTZ
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 1:2300 WALNUT ST APT 212
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2358
Mailing Address - Country:US
Mailing Address - Phone:248-497-3111
Mailing Address - Fax:
Practice Address - Street 1:2152 E 88TH AVE
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-5023
Practice Address - Country:US
Practice Address - Phone:303-227-0400
Practice Address - Fax:303-227-0402
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0018042225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist