Provider Demographics
NPI:1619159936
Name:PACHECO, ERMA MAE (PT)
Entity Type:Individual
Prefix:
First Name:ERMA
Middle Name:MAE
Last Name:PACHECO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2329 W MAIN ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-8210
Mailing Address - Country:US
Mailing Address - Phone:303-797-0988
Mailing Address - Fax:303-797-8011
Practice Address - Street 1:2329 W MAIN ST
Practice Address - Street 2:SUITE 211
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8210
Practice Address - Country:US
Practice Address - Phone:303-797-0988
Practice Address - Fax:303-797-8011
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO2038225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC800345Medicare PIN