Healthcare Provider Details

I. General information

NPI: 1417897489
Provider Name (Legal Business Name): ALLEGRA MCCOMB OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5699 W 20TH ST STE 300
GREELEY CO
80634-3166
US

IV. Provider business mailing address

700 LARKBUNTING DR
FORT COLLINS CO
80526-4154
US

V. Phone/Fax

Practice location:
  • Phone: 970-451-1234
  • Fax:
Mailing address:
  • Phone: 719-271-5801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0009222
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: