NPI 1700883782 · Physical Therapist in Private Practice · Anthem
Moderate evidence supports active practice with 1 carrier network listing and verified licensure.
NPPES
BOULDER, 80303
Freshness: Unknown
Network Status
Listed with 1 carrier
DORA License
Active
Medicare
Non-Medicare specialty
32 beneficiaries
$22,340.13 total payment
Specialty: Physical Therapist in Private Practice
Care Compare
Address matches NPPES
PECOS Enrollment
Medicare enrolled
Active NPI with specialty classification
Active Colorado DORA license confirmed
Active Medicare billing confirmed
Single address source (NPPES)
Weak network corroboration
1 network across 1 carrier
Disclaimer: This analysis uses publicly available federal and state data sources. It does not constitute a determination of provider status or network participation. Contact the provider or health plan directly to verify current status.