Provider Demographics
NPI:1821123746
Name:ALTSCHULER, MAURA R (MPT, DPT)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:R
Last Name:ALTSCHULER
Suffix:
Gender:F
Credentials:MPT, DPT
Other - Prefix:
Other - First Name:MAURA
Other - Middle Name:R
Other - Last Name:MCQUILLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:PO BOX 40000
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:CO
Mailing Address - Zip Code:81658-7520
Mailing Address - Country:US
Mailing Address - Phone:970-668-3169
Mailing Address - Fax:
Practice Address - Street 1:100 BASECAMP WAY STE 105
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443-5967
Practice Address - Country:US
Practice Address - Phone:970-668-3169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16879225100000X
NH2682225100000X
CO000011901225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist