Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 368156299 | OK |
NPI | 1730831538 |
---|---|
Provider Name | Alicia Anne Ward |
First Address | Colorado Springs, CO 80911-2430 |
Second Address | Colorado Springs, CO 80911-2430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2022 |
Last Update Date | 23/01/2022 |