Provider Demographics
NPI:1790072577
Name:MEYER, SHELLEY ANNE (PT, DPT, CLT-LANA)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:ANNE
Last Name:MEYER
Suffix:
Gender:F
Credentials:PT, DPT, CLT-LANA
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:ANNE
Other - Last Name:WAYMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:601 E HAMPDEN AVE
Mailing Address - Street 2:STE 465
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3781
Mailing Address - Country:US
Mailing Address - Phone:303-788-7353
Mailing Address - Fax:303-788-6608
Practice Address - Street 1:601 E HAMPDEN AVE
Practice Address - Street 2:STE 465
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3781
Practice Address - Country:US
Practice Address - Phone:303-788-7353
Practice Address - Fax:303-788-6608
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0013395225100000X
AZ103642251X0800X, 225100000X
WA60227242225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0013395OtherCO DEPARTMENT OF REGULATORY AGENCIES