Organization
PHENOM SPORTS AND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DAVYDOV DPT (OWNER)
(929) 340-1606
Entity
Organization
Contact information
Practice address
10050 RALSTON RD STE 1, ARVADA, CO 80004-4974
(929) 340-1606
Mailing address
10050 RALSTON RD STE 1, ARVADA, CO 80004-4974
(929) 340-1606
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
02/22/2022
Last updated
07/11/2022
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