Provider Demographics
NPI:1437325727
Name:THERESA DELANO'S ATHLETIC THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:THERESA DELANO'S ATHLETIC THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-812-8276
Mailing Address - Street 1:11168 LATIGO LN
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7339
Mailing Address - Country:US
Mailing Address - Phone:716-812-8276
Mailing Address - Fax:
Practice Address - Street 1:11168 LATIGO LN
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7339
Practice Address - Country:US
Practice Address - Phone:716-812-8276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty