Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service |
NPI | 1346675071 |
---|---|
Provider Name | Abigail Vonfeldt |
First Address | Arvada, CO 80003-5653 |
Second Address | Denver, CO 80246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2013 |
Last Update Date | 13/09/2013 |