Individual
INGRID LYN IVERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
755 E 2ND AVE, SUITE E, DURANGO, CO 81301-5498
(970) 385-1773
Mailing address
755 E 2ND AVE, SUITE E, DURANGO, CO 81301-5498
(970) 385-1773
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
CO4074
CO
225100000X
Physical Therapist
NM3725
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO4074
LICENSE
CO
01
—
NM3725
NM LICENSE
NM
Enumeration date
10/27/2009
Last updated
10/27/2009
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