Provider Demographics
NPI:1053902403
Name:LOVELAND, TARA ASHLEY (DPT)
Entity type:Individual
Prefix:MS
First Name:TARA
Middle Name:ASHLEY
Last Name:LOVELAND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5935 S ZANG ST UNIT 9
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4645
Mailing Address - Country:US
Mailing Address - Phone:303-979-5511
Mailing Address - Fax:
Practice Address - Street 1:5935 S ZANG ST UNIT 9
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4645
Practice Address - Country:US
Practice Address - Phone:303-979-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0017425225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist