Provider Demographics
NPI:1982919833
Name:ROBERTS, MEREDITH (DPT)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:ROBERTS
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 1:2222 S FRASER ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014
Mailing Address - Country:US
Mailing Address - Phone:518-466-8301
Mailing Address - Fax:
Practice Address - Street 1:2222 S FRASER ST
Practice Address - Street 2:UNIT 2
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014
Practice Address - Country:US
Practice Address - Phone:518-466-8301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT36684225100000X
DCPT870607225100000X
NCPT12594225100000X
CO11288225100000X
OR6757225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist