Provider Demographics
NPI:1760543888
Name:PRATT, JOYCE E (PT,BS)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:E
Last Name:PRATT
Suffix:
Gender:F
Credentials:PT,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 PARK ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-3849
Mailing Address - Country:US
Mailing Address - Phone:970-580-9356
Mailing Address - Fax:970-522-7990
Practice Address - Street 1:504 PARK ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-3849
Practice Address - Country:US
Practice Address - Phone:970-580-9356
Practice Address - Fax:970-522-7990
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COWAITING ON NUMBERMedicaid