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General NPI Number Information
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NPI Number | 1073322954
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Entity Type | Individual
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Provider Name | MAIZIE NEL DEIHL PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 9108 W 6TH AVE
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City | LAKEWOOD
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State | CO
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Zip | 80215-5121
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Country | US
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Telephone | 303-484-1232
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Fax |
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Provider Business Mailing Address
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Address Line | 742 SILVER MAPLE DR
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City | NEW PRAGUE
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State | MN
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Zip | 56071-4194
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Country | US
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Telephone | 952-217-7064
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL.0020319
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License Number State | CO
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