Provider Demographics
NPI:1295417558
Name:DEINES, STEPHANIE LEE (DPT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LEE
Last Name:DEINES
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 1:1230 TENDERFOOT HILL RD STE 155
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-7346
Mailing Address - Country:US
Mailing Address - Phone:719-527-3383
Mailing Address - Fax:719-527-2688
Practice Address - Street 1:1230 TENDERFOOT HILL RD STE 155
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-7346
Practice Address - Country:US
Practice Address - Phone:719-527-3383
Practice Address - Fax:719-527-2688
Is Sole Proprietor?:No
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19286225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist