Provider Demographics
NPI:1770127219
Name:HALLORAN, SUSAN WINDSOR (DPT)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:WINDSOR
Last Name:HALLORAN
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 1:651 ELM ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-5144
Mailing Address - Country:US
Mailing Address - Phone:303-324-2556
Mailing Address - Fax:
Practice Address - Street 1:651 ELM ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-5144
Practice Address - Country:US
Practice Address - Phone:303-324-2556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1917225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist