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Individual

BRITA DESTEFANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, DPT, PCS

Contact information

Practice address
3015 S GAYLORD ST, DENVER, CO 80210
(512) 573-4651
Mailing address
3015 S GAYLORD ST, DENVER, CO 80210-6023
(512) 573-4651

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
3369
AR
2251P0200X
Pediatric Physical Therapist
Primary
0012137
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
188348721
AR
Enumeration date
10/04/2011
Last updated
09/18/2019
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