Provider Demographics
NPI:1588821672
Name:EDGAR, TERRENCE D (CRT)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:D
Last Name:EDGAR
Suffix:
Gender:M
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8313 S PIERCE WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-6399
Mailing Address - Country:US
Mailing Address - Phone:303-594-6854
Mailing Address - Fax:303-232-0079
Practice Address - Street 1:8313 S PIERCE WAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-6399
Practice Address - Country:US
Practice Address - Phone:303-594-6854
Practice Address - Fax:303-232-0079
Is Sole Proprietor?:No
Enumeration Date:2008-05-18
Last Update Date:2008-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2011227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO2011OtherCO LICENSE