Provider Demographics
NPI:1144429135
Name:EDWARDS, DEBRA DIANE (PT)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:DIANE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:DIANE
Other - Last Name:BRUNEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7362 MCLAUGHLIN RD
Mailing Address - Street 2:
Mailing Address - City:FALCON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-4713
Mailing Address - Country:US
Mailing Address - Phone:719-358-3866
Mailing Address - Fax:719-559-1800
Practice Address - Street 1:7362 MCLAUGHLIN RD
Practice Address - Street 2:
Practice Address - City:FALCON
Practice Address - State:CO
Practice Address - Zip Code:80831-4713
Practice Address - Country:US
Practice Address - Phone:719-358-3866
Practice Address - Fax:719-559-1800
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44932251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000176620Medicaid