Provider Demographics
NPI:1427336510
Name:SIGURDSON, TERESA ANNETTE (PTA)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:ANNETTE
Last Name:SIGURDSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 MOUNTAIN CLOUD CIR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-2207
Mailing Address - Country:US
Mailing Address - Phone:303-317-3104
Mailing Address - Fax:
Practice Address - Street 1:261 MOUNTAIN CLOUD CIR
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-2207
Practice Address - Country:US
Practice Address - Phone:303-317-3104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-24
Last Update Date:2011-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8038066-2402225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant