| Doctor Name: | MR. JUSTIN T DUDLEY |
| NPI Number: | 1023322773 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, DPT |
| License Number: | 10871 |
| Business Practice Address: | 340 E 1st Ave Suite 100 Broomfield, CO - 800202401 |
| Business Phone Number: | 3034600329 |
| Business Fax Number: | 3034600387 |
| Mailing Address: | 1418 Milwaukee St, DENVER |
| State: | CO |
| Postal Code: | 802067000 |
| Phone Number: | 3034600329 |
| Fax Number: | 3034600387 |
| NPI Enumeration Date: | 08/04/2010 |
| NPI Last Update Date: | 08/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 10871 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |