Provider Demographics
NPI:1215409693
Name:DEBLOIS, ABIGAIL (PT)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:DEBLOIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 S MADISON ST STE 303
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3014
Mailing Address - Country:US
Mailing Address - Phone:303-388-1537
Mailing Address - Fax:
Practice Address - Street 1:155 S MADISON ST STE 303
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3014
Practice Address - Country:US
Practice Address - Phone:303-388-1537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-22
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0016091225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic