Provider Demographics
NPI:1891949269
Name:LOBERGER, DEBRA ANN (MT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:LOBERGER
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7480 PLEASANT POINT DR
Mailing Address - Street 2:
Mailing Address - City:RIDGWAY
Mailing Address - State:CO
Mailing Address - Zip Code:81432-8904
Mailing Address - Country:US
Mailing Address - Phone:970-729-0226
Mailing Address - Fax:
Practice Address - Street 1:7480 PLEASANT POINT DR
Practice Address - Street 2:
Practice Address - City:RIDGWAY
Practice Address - State:CO
Practice Address - Zip Code:81432-8904
Practice Address - Country:US
Practice Address - Phone:970-729-0226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO403612-00OtherNATIONAL CERTIFICATION BOARD FOR THERAPUTIC MASSAGE & BODYWORK