| Doctor Name: | MRS. DESIREE BLAIRE BUKOVSKY |
| NPI Number: | 1023279106 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T., DPT |
| License Number: | 22569 |
| Business Practice Address: | 4674 Snow Mesa Dr Suite 140 Fort Collins, CO - 805288615 |
| Business Phone Number: | 9702663850 |
| Business Fax Number: | 9702663855 |
| Mailing Address: | 2312 Limousin Court, FORT COLLINS |
| State: | CO |
| Postal Code: | 80526 |
| Phone Number: | 9705894709 |
| Fax Number: | |
| NPI Enumeration Date: | 06/20/2008 |
| NPI Last Update Date: | 01/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 22569 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |