MEDICARE: DELIA J HERRERA PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	10711	CO

General Provider Information

NPI Number	:	1093035289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELIA J HERRERA PT

Provider Business Mailing Address
First Line	:	8600 PARK MEADOWS DR STE 200
Second Line	:
City	:	LONETREE
State	:	CO
Zip	:	80124-2757
Country	:	US
Telephone Number	:	303-649-2165
Fax Number	:	303-649-2166

Provider Business Practice Location Address
First Line	:	8600 PARK MEADOWS DR STE 200
Second Line	:
City	:	LONETREE
State	:	CO
Zip	:	80124-2757
Country	:	US
Telephone Number	:	303-649-2165
Fax Number	:	303-649-2166

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2010
Last Update Date	:	06/10/2010

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