Provider Demographics
NPI:1639293160
Name:HARRISON, DEBORAH M (PT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:M
Last Name:HARRISON
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 1:1035 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3187
Mailing Address - Country:US
Mailing Address - Phone:303-813-0580
Mailing Address - Fax:303-813-0140
Practice Address - Street 1:1035 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3187
Practice Address - Country:US
Practice Address - Phone:303-813-0580
Practice Address - Fax:303-813-0140
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2779225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO25663Medicare ID - Type UnspecifiedP. T.