Basic Information
| Provider Information | |||||||||
| NPI: | 1962705657 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEGLI | ||||||||
| FirstName: | RAYMOND | ||||||||
| MiddleName: | NICHOLAS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 883299 | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | STEAMBOAT SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804883299 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9708798026 | ||||||||
| FaxNumber: | 9708798046 | ||||||||
| Practice Location | |||||||||
| Address1: | 211 N CLINTON ST | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606611282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308769186 | ||||||||
| FaxNumber: | 6308769187 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2010 | ||||||||
| LastUpdateDate: | 09/15/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PTL0013389 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.