# DIABETES DYNAMICS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518214345
- **Authorized official:** MS. THERESE ANTONELLI LANDIN MA, CDE (CERTIFIED DIABETES EDUCATOR)
- **Authorized official phone:** (970) 390-8311

## Contact information

- **Practice address:** 9 RT. LADYBELLE PL, BOX 5620, EAGLE, CO 81631-5620
- **Practice address phone:** (970) 390-8311
- **Practice address fax:** (970) 328-5497
- **Mailing address:** BOX 5620, 9 RT. LADYBELLE PL, EAGLE, CO 81631-5620
- **Mailing address phone:** (970) 390-8311
- **Mailing address fax:** (970) 328-5497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 09018253 | CO | Yes |

## Other

- **Enumeration date:** 08/10/2012
- **Last updated:** 08/10/2012