Provider Demographics
NPI:1447509153
Name:VELOCITY PHYSICAL THERAPY
Entity type:Organization
Organization Name:VELOCITY PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN DOREN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:303-931-7692
Mailing Address - Street 1:10765 MOUNT BROSS WAY
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8339
Mailing Address - Country:US
Mailing Address - Phone:303-931-7692
Mailing Address - Fax:
Practice Address - Street 1:10765 MOUNT BROSS WAY
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8339
Practice Address - Country:US
Practice Address - Phone:303-931-7692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-10
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86522251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty