Provider Demographics
NPI:1386920023
Name:HENRITZE, JOANNE (MS)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:
Last Name:HENRITZE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1449 LODGE LN
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-8104
Mailing Address - Country:US
Mailing Address - Phone:303-449-0329
Mailing Address - Fax:
Practice Address - Street 1:1449 LODGE LN
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-8104
Practice Address - Country:US
Practice Address - Phone:303-449-0329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist