Provider Demographics
NPI:1679829782
Name:ENTHOVEN, CHRISTIAAN MICHAEL (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAAN
Middle Name:MICHAEL
Last Name:ENTHOVEN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5575 S KENTON WAY
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3963
Mailing Address - Country:US
Mailing Address - Phone:203-570-8681
Mailing Address - Fax:
Practice Address - Street 1:8101 E BELLEVIEW AVE UNIT A-80
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-3306
Practice Address - Country:US
Practice Address - Phone:303-689-2222
Practice Address - Fax:303-773-0804
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL0011764225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist