Provider Demographics
NPI:1144614116
Name:DUMONT, ELIZABETH M (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:M
Last Name:DUMONT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:M
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:6023 NELSON ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-4713
Mailing Address - Country:US
Mailing Address - Phone:720-216-7087
Mailing Address - Fax:
Practice Address - Street 1:13936 W 74TH PL
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-3008
Practice Address - Country:US
Practice Address - Phone:720-216-7087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTA.0013547225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant