Provider Demographics
NPI:1740602895
Name:KREMPASKY, TRICIA KAY (DPT)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:KAY
Last Name:KREMPASKY
Suffix:
Gender:F
Credentials: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 266
Mailing Address - Street 2:
Mailing Address - City:DIVIDE
Mailing Address - State:CO
Mailing Address - Zip Code:80814-0266
Mailing Address - Country:US
Mailing Address - Phone:719-323-0057
Mailing Address - Fax:
Practice Address - Street 1:2150 HOLLOW BROOK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-8413
Practice Address - Country:US
Practice Address - Phone:719-599-5330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012509225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist