Provider Demographics
NPI:1063601292
Name:THOMPSON-ETZEL, ROBYN (ATC, PTA)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:THOMPSON-ETZEL
Suffix:
Gender:F
Credentials:ATC, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:2000 S COLORADO BLVD
Mailing Address - Street 2:TOWER ONE #4500
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-7900
Mailing Address - Country:US
Mailing Address - Phone:720-848-8254
Mailing Address - Fax:720-848-8204
Practice Address - Street 1:2000 S COLORADO BLVD
Practice Address - Street 2:TOWER ONE #4500
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-7900
Practice Address - Country:US
Practice Address - Phone:720-848-8254
Practice Address - Fax:720-848-8204
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2012-03-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
066600Medicare Oscar/Certification