Provider Demographics
NPI:1760226005
Name:MICHAEL, RYAN ALEXANDER (DPT, PT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:ALEXANDER
Last Name:MICHAEL
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 351680
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80035-1680
Mailing Address - Country:US
Mailing Address - Phone:303-382-3700
Mailing Address - Fax:303-832-3712
Practice Address - Street 1:2626 E COLFAX AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1412
Practice Address - Country:US
Practice Address - Phone:303-382-3700
Practice Address - Fax:303-832-3712
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0020039225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist