Provider Demographics
NPI:1841789872
Name:ALEGRE, ROLDAN QUINTOS (DPT)
Entity Type:Individual
Prefix:
First Name:ROLDAN
Middle Name:QUINTOS
Last Name:ALEGRE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 PROFESSIONAL PL STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-8106
Mailing Address - Country:US
Mailing Address - Phone:719-667-1327
Mailing Address - Fax:719-667-1328
Practice Address - Street 1:2950 PROFESSIONAL PL STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-8106
Practice Address - Country:US
Practice Address - Phone:719-667-1327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0018584225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist