Provider Demographics
NPI:1265325328
Name:GERTZ, MCKENZEE JENAVEE (DPT)
Entity type:Individual
Prefix:
First Name:MCKENZEE
Middle Name:JENAVEE
Last Name:GERTZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 IDLEDALE DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5210
Mailing Address - Country:US
Mailing Address - Phone:970-310-8018
Mailing Address - Fax:
Practice Address - Street 1:210 W MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2915
Practice Address - Country:US
Practice Address - Phone:970-221-1201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0020593225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist