Provider Demographics
NPI:1750741609
Name:WIECHMAN, DONNA (PT)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:WIECHMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18282 N CANYON RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-9516
Mailing Address - Country:US
Mailing Address - Phone:303-591-8007
Mailing Address - Fax:
Practice Address - Street 1:18282 N CANYON RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-9516
Practice Address - Country:US
Practice Address - Phone:303-591-8007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL0003330225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist