Provider Demographics
NPI:1679834865
Name:THUENTE, MARY (MSPT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:THUENTE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25577 CONIFER RD
Mailing Address - Street 2:#125
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-9068
Mailing Address - Country:US
Mailing Address - Phone:303-838-7444
Mailing Address - Fax:303-838-7477
Practice Address - Street 1:25577 CONIFER RD
Practice Address - Street 2:#125
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-9068
Practice Address - Country:US
Practice Address - Phone:303-838-7444
Practice Address - Fax:303-838-7477
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7230225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist