Provider Demographics
NPI:1851586325
Name:BEERY, PATRICIA MARIE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MARIE
Last Name:BEERY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:MARIE
Other - Last Name:FELLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:400 SOPRIS AVE
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-2038
Mailing Address - Country:US
Mailing Address - Phone:970-384-6000
Mailing Address - Fax:
Practice Address - Street 1:400 SOPRIS AVE
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-2038
Practice Address - Country:US
Practice Address - Phone:970-384-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8983225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO803381Medicare PIN