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NPI Code Detail

MEDICARE: MR. DEREK HAVERLEY PT, DPT

MEDICARE:  MR. DEREK  HAVERLEY  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
12251X0800XOrthopedic Physical Therapist10828CO

General Provider Information

NPI Number : 1548575368
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DEREK HAVERLEY PT, DPT
Provider Business Mailing Address
First Line : 210 W MAGNOLIA ST STE 110
Second Line :
City : FORT COLLINS
State : CO
Zip : 80521-2915
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 210 W MAGNOLIA ST STE 110
Second Line :
City : FORT COLLINS
State : CO
Zip : 80521-2915
Country : US
Telephone Number : 970-221-1201
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2010
Last Update Date : 08/17/2010

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Directions to “ MR. DEREK HAVERLEY PT, DPT” Practice Location

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