Provider Demographics
NPI:1659503399
Name:ROYLE, VICTORIA MARIE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:MARIE
Last Name:ROYLE
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:PO BOX 5584
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443-5584
Mailing Address - Country:US
Mailing Address - Phone:970-453-3990
Mailing Address - Fax:970-453-2365
Practice Address - Street 1:122 S MAIN ST.
Practice Address - Street 2:UNIT D
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424
Practice Address - Country:US
Practice Address - Phone:970-453-3990
Practice Address - Fax:970-453-2365
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00111802251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO320944YLX1Medicare PIN