Provider Demographics
NPI:1801831672
Name:CHRISTIANSEN, HEATHER L (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:CHRISTIANSEN
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
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 2062
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80522-2062
Mailing Address - Country:US
Mailing Address - Phone:970-213-8577
Mailing Address - Fax:970-672-4804
Practice Address - Street 1:3001 CORTEZ ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2508
Practice Address - Country:US
Practice Address - Phone:970-213-8577
Practice Address - Fax:970-672-4804
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV002492225100000X
CO82692251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist