Provider Demographics
NPI:1649574872
Name:MUNSIL, MICHELE L (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:L
Last Name:MUNSIL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3519 RICHMOND DRIVE
Mailing Address - Street 2:#C
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5994
Mailing Address - Country:US
Mailing Address - Phone:970-493-8727
Mailing Address - Fax:970-493-8739
Practice Address - Street 1:3519 RICHMOND DRIVE
Practice Address - Street 2:#C
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5994
Practice Address - Country:US
Practice Address - Phone:970-493-8727
Practice Address - Fax:970-493-8739
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10114225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist