Provider Demographics
NPI:1275136905
Name:PEHRINGER, DEA M (LMT, HHP)
Entity Type:Individual
Prefix:
First Name:DEA
Middle Name:M
Last Name:PEHRINGER
Suffix:
Gender:F
Credentials:LMT, HHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13029 COUNTY ROAD 38
Mailing Address - Street 2:
Mailing Address - City:PLATTEVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80651-8630
Mailing Address - Country:US
Mailing Address - Phone:970-515-7329
Mailing Address - Fax:
Practice Address - Street 1:13029 COUNTY ROAD 38
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:CO
Practice Address - Zip Code:80651-8630
Practice Address - Country:US
Practice Address - Phone:970-515-7329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT0009664225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist