MEDICARE: MRS. TRUDY MIRANDA HARVEY PT, DPT, OCS, CFMT

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	PTL 0012616	CO
2	225100000X	Physical Therapist	3377	NM
3	225100000X	Physical Therapist	1166253	TX

General Provider Information

NPI Number	:	1861802522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TRUDY MIRANDA HARVEY PT, DPT, OCS, CFMT

Provider Business Mailing Address
First Line	:	1856 LINCOLN AVE
Second Line	:
City	:	STEAMBOAT SPRINGS
State	:	CO
Zip	:	80487-5046
Country	:	US
Telephone Number	:	970-879-4558
Fax Number	:

Provider Business Practice Location Address
First Line	:	1856 LINCOLN AVE
Second Line	:
City	:	STEAMBOAT SPRINGS
State	:	CO
Zip	:	80487-5046
Country	:	US
Telephone Number	:	970-879-4558
Fax Number	:

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

Provider Enumeration Date	:	05/04/2014
Last Update Date	:	05/04/2014

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