Organization
ADVANCED PHYSICAL & SPORTS THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS HECKENKAMP MPT (OWNER)
(720) 733-3655
Entity
Organization
Contact information
Practice address
880 HAPPY CANYON RD STE 145, CASTLE ROCK, CO 80108-3915
(720) 733-3655
(720) 733-3656
Mailing address
880 HAPPY CANYON RD STE 145, CASTLE ROCK, CO 80108-3915
(720) 733-3655
(720) 733-3656
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6646
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6646
STATE LICENSE
CO
01
—
AD659056
BLUE CROSS BLUE SHIELD
CO
Enumeration date
04/04/2007
Last updated
09/11/2007
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