Provider Demographics
NPI:1811043250
Name:PACE, YVONNE M (PT)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:M
Last Name:PACE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:576 CATALINA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-5141
Mailing Address - Country:US
Mailing Address - Phone:719-576-2542
Mailing Address - Fax:
Practice Address - Street 1:7606 N UNION BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3850
Practice Address - Country:US
Practice Address - Phone:719-667-0666
Practice Address - Fax:719-594-5658
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2509225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist