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Individual

MS. MICHELLE DECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
8540 SCARBOROUGH DR, SUITE #200, COLORADO SPRINGS, CO 80920-7502
(719) 630-7500
Mailing address
8540 SCARBOROUGH DR, SUITE #200, COLORADO SPRINGS, CO 80920-7502
(719) 630-7500

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
0284A
AZ
225200000X
Physical Therapy Assistant
Primary
PTA48929
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0284A
AZ
Enumeration date
07/02/2015
Last updated
06/11/2019
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