MEDICARE: ALLY MARIA LASSETTER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PTL.0021285	CO

General Provider Information

NPI Number	:	1457282022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLY MARIA LASSETTER DPT

Provider Business Mailing Address
First Line	:	1415 S DAHLIA ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-3529
Country	:	US
Telephone Number	:	916-512-0651
Fax Number	:

Provider Business Practice Location Address
First Line	:	1415 S DAHLIA ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-3529
Country	:	US
Telephone Number	:	916-512-0651
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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Directions to “ ALLY MARIA LASSETTER DPT” Practice Location

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