Provider Demographics
NPI:1942428891
Name:O'BRIEN, MARGARET THERESE (MPT LPT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:THERESE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MPT LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 235
Mailing Address - Street 2:
Mailing Address - City:WOODY CREEK
Mailing Address - State:CO
Mailing Address - Zip Code:81656-0235
Mailing Address - Country:US
Mailing Address - Phone:970-923-9666
Mailing Address - Fax:
Practice Address - Street 1:0006 WOODY CREEK PLAZA
Practice Address - Street 2:
Practice Address - City:WOODY CREEK
Practice Address - State:CO
Practice Address - Zip Code:81656
Practice Address - Country:US
Practice Address - Phone:970-923-9666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3296225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO24542OtherFEIN