Provider Demographics
NPI:1285154005
Name:MESMER, DAVID TROY (PTA)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:TROY
Last Name:MESMER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12387 S WAMBLEE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-6204
Mailing Address - Country:US
Mailing Address - Phone:303-946-2222
Mailing Address - Fax:
Practice Address - Street 1:12387 S WAMBLEE VALLEY RD
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433
Practice Address - Country:US
Practice Address - Phone:303-946-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTA.0012498225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant