Healthcare Provider Details

I. General information

NPI: 1437464708
Provider Name (Legal Business Name): ALETA IRENE-RUTH HAUSER P.T., D.P.T., C.L.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 S MAIN ST
DELTA CO
81416-2407
US

IV. Provider business mailing address

63715 IDA RD
MONTROSE CO
81401-9260
US

V. Phone/Fax

Practice location:
  • Phone: 970-874-9773
  • Fax:
Mailing address:
  • Phone: 970-240-2746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9171
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: