Provider Demographics
NPI:1457657553
Name:REARDANZ, JOANNE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:
Last Name:REARDANZ
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 1:2440 LUMBERJACK DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1446
Mailing Address - Country:US
Mailing Address - Phone:719-599-8872
Mailing Address - Fax:
Practice Address - Street 1:7665 ASSISI HEIGHTS
Practice Address - Street 2:MOUNT ST FRANCIS
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919
Practice Address - Country:US
Practice Address - Phone:719-598-1336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO67782251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics