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Individual

MRS. SRIPRIYA MADURA PRINCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
2211 S COLLEGE AVE, SUITE 300, FORT COLLINS, CO 80525-1489
(970) 663-6142
(970) 635-3087
Mailing address
107 W 29TH ST, SUITE 100, LOVELAND, CO 80538-2797
(970) 663-6142
(970) 635-3087

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
035496
NY
225100000X
Physical Therapist
035496
NY
2251S0007X
Sports Physical Therapist
035496
NY
2251X0800X
Orthopedic Physical Therapist
035496
NY
2251X0800X
Orthopedic Physical Therapist
Primary
14190
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12388094
CAQH
Enumeration date
08/30/2012
Last updated
03/16/2017
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