Provider Demographics
NPI:1457791931
Name:DANKELMAN, TERRI (PTA)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:DANKELMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 S MONACO PKWY
Mailing Address - Street 2:212
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5841
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2280 S MONACO PKWY
Practice Address - Street 2:212
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5841
Practice Address - Country:US
Practice Address - Phone:303-594-6793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012299225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0012299OtherMEDICARE