Provider Demographics
NPI:1346653920
Name:OVIATT, GRACE KATHERINE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:KATHERINE
Last Name:OVIATT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 STEEL ST UNIT 4306
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-8541
Mailing Address - Country:US
Mailing Address - Phone:720-987-6553
Mailing Address - Fax:
Practice Address - Street 1:11575 MAIN ST UNIT 100
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2782
Practice Address - Country:US
Practice Address - Phone:303-467-2288
Practice Address - Fax:303-410-0100
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012718225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist