Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 10715 | CO |
NPI | 1093014490 |
---|---|
Provider Name | Ashley Alvarez |
First Address | Woodland Park, CO 80863-9612 |
Second Address | Woodland Park, CO 80863-9612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2011 |
Last Update Date | 24/03/2011 |