Provider Demographics
NPI:1821677170
Name:DOCKEN, DANELLE ANN (DPT)
Entity Type:Individual
Prefix:
First Name:DANELLE
Middle Name:ANN
Last Name:DOCKEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DANELLE
Other - Middle Name:ANN
Other - Last Name:DOCKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 ASPEN CT
Mailing Address - Street 2:
Mailing Address - City:PARACHUTE
Mailing Address - State:CO
Mailing Address - Zip Code:81635-9675
Mailing Address - Country:US
Mailing Address - Phone:253-315-0370
Mailing Address - Fax:
Practice Address - Street 1:501 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650-8510
Practice Address - Country:US
Practice Address - Phone:970-625-1510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0017548225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty