- Practice location
- 2611 Jones Ave, Pueblo, CO 81004-2650
- Phone
- 719-564-1735
- Fax
- —
- Last updated
- January 19, 2023
Ivan Ivanov is a Physical Therapist based in Pueblo, CO. Ivan Ivanov practices in Pueblo, CO and has the professional credentials of PT. The NPI Number for Ivan Ivanov is 1942832803 and holds a License No. J1-0004181 (DE). The current practice location address for Ivan Ivanov is 2611 Jones Ave, Pueblo, CO 81004-2650 and can be reached out via phone at 719-564-1735.
Provider Profile Details
- NPI Number
- 1942832803
- Provider Name
- Ivan Ivanov
- Credential
- PT
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 2611 Jones Ave, Pueblo, CO 81004-2650
- Phone Number
- 719-564-1735
- Primary Taxonomy
- Physical Therapist · 225100000X
- Sole Proprietor
- No
- Provider Enumeration Date
- February 10, 2020
- Last Update Date
- January 19, 2023
- Certification Date
- January 19, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 2611 Jones Ave
Pueblo, CO 81004-2650 - City
- Pueblo
- State
- Colorado
- Zip
- 81004-2650
- Phone Number
- 719-564-1735
Provider Business Mailing Address Details
- Address
- 655 S Willow St Ste 128
Manchester, NH 03103-5723 - City
- Manchester
- State
- NH
- Zip
- 03103-5723
- Phone Number
- 800-995-2673
License Information
- Taxonomy (1)
- Physical Therapist · 225100000X
- License Number (2)
- J1-0004181
- License State (2)
- DE
- Taxonomy (2)
- Physical Therapist · 225100000X
- License Number (3)
- CP017621T
- License State (3)
- CO
- Taxonomy (3)
- Physical Therapist · 225100000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Ivan Ivanov, PT?
The NPI number of Ivan Ivanov, PT is 1942832803. It was assigned on February 10, 2020 and is currently active in the NPPES registry.
What is the specialty of Ivan Ivanov, PT?
Ivan Ivanov, PT is registered under the primary taxonomy Physical Therapist (code 225100000X), licensed in DE under license number J1-0004181.
Where does Ivan Ivanov, PT practice?
The practice location is 2611 Jones Ave, Pueblo, CO 81004-2650. The office can be reached at 719-564-1735 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1942832803 directly on the NPPES registry website.