Terry L Dezeeuw, ATC
Specialist/Technologist, Athletic Trainer in Fort Collins, CO. Individual provider (NPI-1).
NPI number1437176120
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1437176120
- Entity type
- Individual (NPI-1)
- Name
- Mr. Terry L Dezeeuw
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 17, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 36000536A | IN | Yes |
Practice location
Colorado State UniversityMcgraw Athletic Center
Fort Collins, CO 80523-0001
Phone 970-491-6756 · Fax 970-491-6167
Mailing address
Colorado State UniversityMcgraw Athletic Center
Fort Collins, CO 80523-0001
Phone 970-491-6756 · Fax 970-491-6167
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