Provider Demographics
NPI:1205985876
Name:EAMAN, MARY FRANCIS (PT)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:FRANCIS
Last Name:EAMAN
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 1:1310 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501
Mailing Address - Country:US
Mailing Address - Phone:303-772-2255
Mailing Address - Fax:303-774-1395
Practice Address - Street 1:1310 BAKER ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501
Practice Address - Country:US
Practice Address - Phone:303-772-2255
Practice Address - Fax:303-774-1395
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2889225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
496338Medicare ID - Type Unspecified