Provider Demographics
NPI:1669342937
Name:DEEGAN, JOVITA (DPT)
Entity type:Individual
Prefix:
First Name:JOVITA
Middle Name:
Last Name:DEEGAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6825 MESA RIDGE PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-1784
Mailing Address - Country:US
Mailing Address - Phone:719-623-1110
Mailing Address - Fax:719-623-1144
Practice Address - Street 1:6825 MESA RIDGE PKWY STE 150
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-1784
Practice Address - Country:US
Practice Address - Phone:719-623-1110
Practice Address - Fax:719-623-1144
Is Sole Proprietor?:No
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20944225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist