Provider Demographics
NPI:1003807207
Name:TESTA, AMY E (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:E
Last Name:TESTA
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:E
Other - Last Name:CLAPPROOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:3600 MAIN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4000
Mailing Address - Country:US
Mailing Address - Phone:970-259-7829
Mailing Address - Fax:970-259-9411
Practice Address - Street 1:3600 MAIN AVE STE A
Practice Address - Street 2:SUITE 3
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4031
Practice Address - Country:US
Practice Address - Phone:970-259-7829
Practice Address - Fax:970-259-9411
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8390225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO41088824Medicaid
CO41088824Medicaid