Provider Demographics
NPI:1982959185
Name:AGNEW, ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:AGNEW
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:275 CENTURY CIR
Mailing Address - Street 2:#103
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9729
Mailing Address - Country:US
Mailing Address - Phone:303-926-1444
Mailing Address - Fax:303-926-0038
Practice Address - Street 1:275 CENTURY CIR
Practice Address - Street 2:SUITE 103
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9729
Practice Address - Country:US
Practice Address - Phone:303-926-1444
Practice Address - Fax:303-926-0038
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011753225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0011753OtherSTATE PT LICENSE