Provider Demographics
NPI:1033354204
Name:WINTER, TERRY R (CMT)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:R
Last Name:WINTER
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:R
Other - Last Name:WINTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CMT
Mailing Address - Street 1:1045 ACOMA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4029
Mailing Address - Country:US
Mailing Address - Phone:303-912-4861
Mailing Address - Fax:
Practice Address - Street 1:1045 ACOMA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4029
Practice Address - Country:US
Practice Address - Phone:303-912-4861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1607225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist