Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PTL0010675 | CO |
NPI | 1104904713 |
---|---|
Provider Name | Beth Ann Sun |
First Address | Aurora, CO 80011-6716 |
Second Address | Aurora, CO 80011-6716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 24/10/2019 |