Provider Demographics
NPI:1881877710
Name:GREGORY, DANA L (DPT)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:GREGORY
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 1:1889 WOODMOOR DR
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-9066
Mailing Address - Country:US
Mailing Address - Phone:719-481-6868
Mailing Address - Fax:719-481-6977
Practice Address - Street 1:1889 WOODMOOR DR
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-9066
Practice Address - Country:US
Practice Address - Phone:719-481-6868
Practice Address - Fax:719-481-6977
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8596225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist