Julia Ann Ebert, PT, DPT
Individual provider Active NPI Physical Therapist · Lyons, CO
NPI 1144779018 · NPPES record last updated Oct 3, 2016
Key facts
- NPI
- 1144779018
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 14284 (CO)
- Practice address
- 435 High St
Lyons, CO 80540 - Phone
- (760) 846-2144
- NPI assigned
- Oct 3, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14284 | CO | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 14284 | CO | Yes |
Addresses
Primary practice location
435 High St
Lyons, CO 80540
Mailing address
PO Box 19586
Boulder, CO 80308-2586
Other providers in Lyons, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.