Provider Demographics
NPI:1487960290
Name:DOOLITTLE, HAVEN
Entity type:Individual
Prefix:
First Name:HAVEN
Middle Name:
Last Name:DOOLITTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3119 BORROSSA ST
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:CO
Mailing Address - Zip Code:80634-8896
Mailing Address - Country:US
Mailing Address - Phone:970-518-2964
Mailing Address - Fax:
Practice Address - Street 1:5300 W 29TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-8399
Practice Address - Country:US
Practice Address - Phone:970-330-5646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist