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General NPI Number Information
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NPI Number | 1861900532
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Entity Type | Individual
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Provider Name | MICHELLE ELIZABETH OBERNDORF DPT
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Gender | Female
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Dates
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Enumeration Date | 01/16/2018
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 2004 N 12TH ST
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-2982
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Country | US
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Telephone | 970-644-3720
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Fax |
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Provider Business Mailing Address
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Address Line | 410 25 RD
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City | GRAND JUNCTION
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State | CO
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Zip | 81507-1602
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Country | US
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Telephone |
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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.0015371
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License Number State | CO
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