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General NPI Number Information
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NPI Number | 1497874846
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Entity Type | Individual
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Provider Name | DANIEL DEPPERMAN NCMMT, CERT ROLFER
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1301 S 8TH ST STE 112
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-1340
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Country | US
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Telephone | 719-321-6579
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Fax | 719-634-5549
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Provider Business Mailing Address
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Address Line | 1301 S 8TH ST STE 112
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-1340
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Country | US
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Telephone | 719-321-6579
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Fax | 719-634-5549
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 702591
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License Number State | CO
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