Basic Information
| Provider Information | |||||||||
| NPI: | 1992752174 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GONDER | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | M.S.P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10081 WADSWORTH PKWY | ||||||||
| Address2: | STE 120 | ||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800213827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036942295 | ||||||||
| FaxNumber: | 3036941843 | ||||||||
| Practice Location | |||||||||
| Address1: | 1371 E HECLA DR | ||||||||
| Address2: | STE E | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800272327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036656064 | ||||||||
| FaxNumber: | 3036655493 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2006 | ||||||||
| LastUpdateDate: | 11/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 8902 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.