Provider Demographics
NPI:1447220108
Name:GLUTH, VALERIE JEANNE (PT)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:JEANNE
Last Name:GLUTH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-4212
Mailing Address - Country:US
Mailing Address - Phone:303-670-8933
Mailing Address - Fax:
Practice Address - Street 1:1262 BERGEN PKWY
Practice Address - Street 2:E10
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-9546
Practice Address - Country:US
Practice Address - Phone:303-674-7889
Practice Address - Fax:303-674-8117
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3974225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP6223Medicare ID - Type Unspecified