Basic Information
| Provider Information | |||||||||
| NPI: | 1053047548 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DLUGOSZ | ||||||||
| FirstName: | MICAELA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4031 BURTON ST | ||||||||
| Address2: | |||||||||
| City: | STRASBURG | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801368097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7208919728 | ||||||||
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| Practice Location | |||||||||
| Address1: | 56171 E COLFAX AVE | ||||||||
| Address2: | #6 | ||||||||
| City: | STRASBURG | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036226688 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2022 | ||||||||
| LastUpdateDate: | 07/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PTL.0018525 | CO | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.