Provider Demographics
NPI:1760938443
Name:FITZPATRICK, MICHELLE NICOLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:NICOLE
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:NICOLE
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14285 DENVER WEST CIR
Mailing Address - Street 2:APT 6410
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3359
Mailing Address - Country:US
Mailing Address - Phone:574-606-6253
Mailing Address - Fax:
Practice Address - Street 1:9351 GRANT ST
Practice Address - Street 2:STE 430
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4358
Practice Address - Country:US
Practice Address - Phone:303-280-1211
Practice Address - Fax:303-280-2232
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014334225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist