Vastenburg, Antoinette

Vastenburg, Antoinette is an individual health care provider with primary practice located at 4150 Darley Ave Suite8, Boulder CO 80305-6557. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. Vastenburg, Antoinette can be contacted via phone (303) 494-4100.

Contact Information

Primary practice address
4150 Darley Ave Suite8 Boulder CO 80305-6557
Phone: (303) 494-4100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 3608 Colorado
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports 2251S0007X 3608 Colorado

Profile Details

NPI number 1205960234
LBN Legal business name Vastenburg, Antoinette
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2007
Last updated Mar 2nd, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205960234 NPPES
Colorado MEDICAID 64770095

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