Spencer Jacob Tannenbaum, PT, DPT
Physical Therapist in Evergreen, CO. Individual provider (NPI-1).
NPI number1730833609
StatusActive
Last updated in NPPESFeb 9, 2022
Details
- NPI
- 1730833609
- Entity type
- Individual (NPI-1)
- Name
- Spencer Jacob Tannenbaum
- Credential
- PT, DPT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 9, 2022
- Certification date
- Feb 9, 2022
- Last updated
- Feb 9, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 18195 | CO | Yes |
Practice location
1262 Bergen Pkwy Unit E10Evergreen, CO 80439-9546
Phone 303-674-7889
Mailing address
1262 Bergen Pkwy Unit E10Evergreen, CO 80439-9546
Phone 303-674-7889
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All 63 Physical Therapist providers in Evergreen · All 664 providers in Evergreen
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