Provider Demographics
NPI:1467790956
Name:CLIPPINGER, CELESTE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:CELESTE
Middle Name:
Last Name:CLIPPINGER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3470 DACORO LANE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109
Mailing Address - Country:US
Mailing Address - Phone:619-933-7821
Mailing Address - Fax:
Practice Address - Street 1:3470 DACORO LANE
Practice Address - Street 2:SUITE 105
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109
Practice Address - Country:US
Practice Address - Phone:619-933-7821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00111012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO208100000XMedicare PIN