Individual
CONNOR VAN BAVEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.SC.P.T.
Contact information
Practice address
12297 PENNSYLVANIA ST, SUITE 3, THORNTON, CO 80241-3165
(303) 252-9400
(303) 255-9555
Mailing address
13606 XAVIER LN, UNIT C, BROOMFIELD, CO 80023-3604
(303) 404-9494
(303) 404-2252
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL.0012807
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000144743
—
CO
Enumeration date
09/17/2014
Last updated
04/22/2017
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