Provider Demographics
NPI:1740290220
Name:TEGETHOFF, DONNA S (PT)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:S
Last Name:TEGETHOFF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2032 LOWE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5741
Mailing Address - Country:US
Mailing Address - Phone:970-223-6339
Mailing Address - Fax:970-223-6382
Practice Address - Street 1:1160 E 130TH AVE
Practice Address - Street 2:UNIT B
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3933
Practice Address - Country:US
Practice Address - Phone:970-213-3087
Practice Address - Fax:303-452-3087
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2008-11-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO3125225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC806303Medicare PIN