Provider Demographics
NPI:1134516263
Name:DOUCETTE, COLENE (LMT)
Entity Type:Individual
Prefix:
First Name:COLENE
Middle Name:
Last Name:DOUCETTE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8040 E MORGAN TRL
Mailing Address - Street 2:STE 10B
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1232
Mailing Address - Country:US
Mailing Address - Phone:480-459-1050
Mailing Address - Fax:
Practice Address - Street 1:8040 E MORGAN TRL
Practice Address - Street 2:STE 10B
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-1232
Practice Address - Country:US
Practice Address - Phone:480-459-1050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-05437172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist