Provider Demographics
NPI:1649380031
Name:LAFERRIERE, HEATHER (PT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:LAFERRIERE
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 1:5350 MANHATTAN CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-4272
Mailing Address - Country:US
Mailing Address - Phone:303-543-1201
Mailing Address - Fax:303-543-1206
Practice Address - Street 1:5350 MANHATTAN CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-4272
Practice Address - Country:US
Practice Address - Phone:303-543-1201
Practice Address - Fax:303-543-1206
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT007406OtherLICENSE#
CO10172OtherPT LICENSE