Provider Demographics
NPI:1821658337
Name:TEMPLE, ELIZABETH JORDAN SMITH (DPT)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:JORDAN SMITH
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3470 CENTENNIAL BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4091
Mailing Address - Country:US
Mailing Address - Phone:710-632-6818
Mailing Address - Fax:
Practice Address - Street 1:3470 CENTENNIAL BLVD STE 115
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4091
Practice Address - Country:US
Practice Address - Phone:710-632-6818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0016427225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist