Provider Demographics
NPI:1053400192
Name:NORGREN, GEORGIA LYNN (DPT)
Entity type:Individual
Prefix:MISS
First Name:GEORGIA
Middle Name:LYNN
Last Name:NORGREN
Suffix:
Gender:F
Credentials:DPT
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 283
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80482-0283
Mailing Address - Country:US
Mailing Address - Phone:303-726-9805
Mailing Address - Fax:
Practice Address - Street 1:554 BAKER DRIVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:CO
Practice Address - Zip Code:80482-0283
Practice Address - Country:US
Practice Address - Phone:303-726-9805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7050225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist