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Individual

MARA DANIELLE PACYGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSPT

Contact information

Practice address
280 ZEREX ST., POB 1345, FRASER, CO 80442-1345
(970) 726-8503
(970) 726-8941
Mailing address
280 ZEREX ST, POB 1345, FRASER, CO 80442-1345
(970) 726-8503
(970) 726-8941

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
7663
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7663
STATE PT LICENSE
CO
Enumeration date
12/15/2006
Last updated
01/23/2008
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