Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | ||
N | 2251C2600X | Cardiopulmonary | ||
N | 2251G0304X | Physical Therapist - Geriatrics | ||
N | 2251N0400X | Physical Therapist - Neurology | ||
N | 2251S0007X | Physical Therapist - Sports | ||
Y | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1417365974 |
---|---|
Provider Name | Ben Mark Kottmeyer |
First Address | Aurora, CO 80012-5689 |
Second Address | Aurora, CO 80012-5689 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2014 |
Last Update Date | 21/05/2021 |