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NPI Code Detail

MEDICARE: DR. MARY ELLINGTON POMEROY WINTERSIECK PT, DPT

MEDICARE: DR. MARY ELLINGTON POMEROY WINTERSIECK PT, DPT
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
1225100000XPhysical TherapistPTL.0011783CO

General Provider Information

NPI Number : 1437405644
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY ELLINGTON POMEROY WINTERSIECK PT, DPT
Provider Business Mailing Address
First Line : 9351 GRANT ST STE 430
Second Line :
City : THORNTON
State : CO
Zip : 80229-4365
Country : US
Telephone Number : 303-280-1211
Fax Number :
Provider Business Practice Location Address
First Line : 9351 GRANT ST STE 430
Second Line :
City : THORNTON
State : CO
Zip : 80229-4365
Country : US
Telephone Number : 303-280-1211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2012
Last Update Date : 12/04/2017

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