Healthcare Provider Details

I. General information

NPI: 1770845406
Provider Name (Legal Business Name): WENDY ANN EVANS MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2012
Last Update Date: 11/16/2025
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 SOUTH ELIZABETH ST
ELIZABETH CO
80107-7575
US

IV. Provider business mailing address

7622 MCLAUGHLIN RD
PEYTON CO
80831-4710
US

V. Phone/Fax

Practice location:
  • Phone: 303-646-1445
  • Fax: 719-471-4415
Mailing address:
  • Phone: 719-495-3133
  • Fax: 719-471-4415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number6262
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0006262
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: