Provider Demographics
NPI:1902950710
Name:ELGES, DEANNA LINETTE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:LINETTE
Last Name:ELGES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2673 S MOORE DR APT 103
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-2735
Mailing Address - Country:US
Mailing Address - Phone:720-231-4759
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:2007-01-22
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13211225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant