Provider Demographics
NPI:1487685400
Name:PFAUTZ, ROBIN SEVERY (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:SEVERY
Last Name:PFAUTZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 295
Mailing Address - Street 2:
Mailing Address - City:WOODY CREEK
Mailing Address - State:CO
Mailing Address - Zip Code:81656-0295
Mailing Address - Country:US
Mailing Address - Phone:970-618-6347
Mailing Address - Fax:970-429-4140
Practice Address - Street 1:141 LOWER BULLWINKLE LN
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-2255
Practice Address - Country:US
Practice Address - Phone:970-618-6347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8949225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist