Provider Demographics
NPI:1609583616
Name:D'ANGELO, ELENA MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:MARIE
Last Name:D'ANGELO
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 1:13731 BASALT CT
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-6072
Mailing Address - Country:US
Mailing Address - Phone:303-906-2677
Mailing Address - Fax:
Practice Address - Street 1:13731 BASALT CT
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-6072
Practice Address - Country:US
Practice Address - Phone:303-906-2677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0017776225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist