Provider Demographics
NPI:1194483891
Name:STANGE, TERRY (PHD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:
Last Name:STANGE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7895 BLACKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-8022
Mailing Address - Country:US
Mailing Address - Phone:970-646-3351
Mailing Address - Fax:
Practice Address - Street 1:7895 BLACKWOOD DR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-8022
Practice Address - Country:US
Practice Address - Phone:970-646-3351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor