Provider Demographics
NPI:1326209875
Name:KONCAR, DEANNA KRISTEN (PT)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:KRISTEN
Last Name:KONCAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:KRISTEN
Other - Last Name:BEYHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1690 30TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1034
Mailing Address - Country:US
Mailing Address - Phone:303-447-2873
Mailing Address - Fax:303-447-2741
Practice Address - Street 1:1690 30TH ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1034
Practice Address - Country:US
Practice Address - Phone:303-447-2873
Practice Address - Fax:303-447-2741
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10373225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist