Provider Demographics
NPI:1265538128
Name:PLEASANT, VALERIE J (PT)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:J
Last Name:PLEASANT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 711185
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84171-1185
Mailing Address - Country:US
Mailing Address - Phone:801-942-3311
Mailing Address - Fax:801-942-5955
Practice Address - Street 1:473 YAMPA AVE
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2609
Practice Address - Country:US
Practice Address - Phone:970-824-9359
Practice Address - Fax:970-824-6777
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3552225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO066581Medicare ID - Type Unspecified