Provider Demographics
NPI:1184969263
Name:GAREY, WENDY DIANE (P T)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:DIANE
Last Name:GAREY
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6540 CRESTBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:CO
Mailing Address - Zip Code:80465-2234
Mailing Address - Country:US
Mailing Address - Phone:303-697-5897
Mailing Address - Fax:
Practice Address - Street 1:150 SPRING ST
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:CO
Practice Address - Zip Code:80465-2532
Practice Address - Country:US
Practice Address - Phone:303-697-9714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-30
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004518225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist