Provider Demographics
NPI:1164810636
Name:LITTER, EDWIN (LMT)
Entity Type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:
Last Name:LITTER
Suffix:
Gender:M
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:PO BOX 433
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80539-0433
Mailing Address - Country:US
Mailing Address - Phone:970-690-5528
Mailing Address - Fax:
Practice Address - Street 1:1762 HOFFMAN DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-4292
Practice Address - Country:US
Practice Address - Phone:970-690-5582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-06
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT0003480172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist