Provider Demographics
NPI:1588872618
Name:HUDSON, DANA BRESSAN (PT)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:BRESSAN
Last Name:HUDSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:253 GLENMOOR RD
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-2715
Mailing Address - Country:US
Mailing Address - Phone:719-276-2757
Mailing Address - Fax:719-275-1988
Practice Address - Street 1:915 INDUSTRIAL ST
Practice Address - Street 2:SUITE B
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-3842
Practice Address - Country:US
Practice Address - Phone:719-275-1014
Practice Address - Fax:719-275-1988
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO4347225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO065217Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER