Provider Demographics
NPI:1497291363
Name:COLANGELO, DAVID (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:COLANGELO
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 1/2 PETERSON ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3727
Mailing Address - Country:US
Mailing Address - Phone:904-651-4435
Mailing Address - Fax:
Practice Address - Street 1:1110 1/2 PETERSON ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3727
Practice Address - Country:US
Practice Address - Phone:904-651-4435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004830225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist