Provider Demographics
NPI:1760127492
Name:TEFFT, ALLEN J (LMT)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:J
Last Name:TEFFT
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 HOLLADAY CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-3326
Mailing Address - Country:US
Mailing Address - Phone:970-215-5182
Mailing Address - Fax:
Practice Address - Street 1:1501 CLEVELAND AVE STE E
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-3835
Practice Address - Country:US
Practice Address - Phone:970-215-5182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0021829225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist