Provider Demographics
NPI:1083755623
Name:BRELIG, PATRICIA GAYLE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:GAYLE
Last Name:BRELIG
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 RANGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-1920
Mailing Address - Country:US
Mailing Address - Phone:970-484-6873
Mailing Address - Fax:
Practice Address - Street 1:COLORADO STATE UNIVERSITY HHS-8031 CAMPUS DELIVERY
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80523-8031
Practice Address - Country:US
Practice Address - Phone:970-491-1735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO688225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist