Provider Demographics
NPI:1275978348
Name:STEERE, DAVID (PTA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:STEERE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9960 PROMINENT PEAK HTS
Mailing Address - Street 2:#301
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-8646
Mailing Address - Country:US
Mailing Address - Phone:719-964-8200
Mailing Address - Fax:
Practice Address - Street 1:9960 PROMINENT PEAK HTS
Practice Address - Street 2:#301
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924-8646
Practice Address - Country:US
Practice Address - Phone:719-964-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013129225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0013129OtherMEDICARE