Provider Demographics
NPI:1013947985
Name:GLATFELTER, PATRICIA ANN (PT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:GLATFELTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:989 MATTERHORN DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:CO
Mailing Address - Zip Code:80816-9017
Mailing Address - Country:US
Mailing Address - Phone:719-689-3174
Mailing Address - Fax:707-443-8628
Practice Address - Street 1:989 MATTERHORN DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:CO
Practice Address - Zip Code:80816-9017
Practice Address - Country:US
Practice Address - Phone:719-689-3174
Practice Address - Fax:707-825-7245
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 9944174400000X
COPTL0001282225100000X
CAPT9944225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA650021072OtherRR MEDICARE #
CAOOPT99440Medicare ID - Type Unspecified