Provider Demographics
NPI:1295060689
Name:SUNDSETH, MAURA E (DPT)
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:E
Last Name:SUNDSETH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MAURA
Other - Middle Name:E
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12662 JERSEY CIR E
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-4658
Mailing Address - Country:US
Mailing Address - Phone:720-213-5513
Mailing Address - Fax:720-213-5125
Practice Address - Street 1:12662 JERSEY CIR E
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80602-4658
Practice Address - Country:US
Practice Address - Phone:720-213-5513
Practice Address - Fax:720-213-5125
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9885225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist