Provider Demographics
NPI:1942291141
Name:TESTA, MICHAEL T (MSPT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:T
Last Name:TESTA
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:801 FLORIDA RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4780
Mailing Address - Country:US
Mailing Address - Phone:970-259-7829
Mailing Address - Fax:970-259-9411
Practice Address - Street 1:801 FLORIDA RD
Practice Address - Street 2:SUITE 3
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4780
Practice Address - Country:US
Practice Address - Phone:970-259-7829
Practice Address - Fax:970-259-9411
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2008-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO7886225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO17787726Medicaid
CO17787726Medicaid