Provider Demographics
NPI:1104216043
Name:DEGRANDIS, CHRIS (PT, DPT, CFMT)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:DEGRANDIS
Suffix:
Gender:F
Credentials:PT, DPT, CFMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1843 KALEL LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-8562
Mailing Address - Country:US
Mailing Address - Phone:440-213-0909
Mailing Address - Fax:
Practice Address - Street 1:777 29TH ST STE 401
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2316
Practice Address - Country:US
Practice Address - Phone:440-213-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL00126522251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic