Provider Demographics
NPI:1730698119
Name:FLETCHER, TERESA ANN (MSPT)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:ANN
Other - Last Name:GASSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5545 LOYOLA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-8133
Mailing Address - Country:US
Mailing Address - Phone:719-310-3386
Mailing Address - Fax:
Practice Address - Street 1:5545 LOYOLA DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-8133
Practice Address - Country:US
Practice Address - Phone:719-310-3386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0014362225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist