Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | 998 | CO |
NPI | 1548328032 |
---|---|
Provider Name | Connie C Cory |
First Address | Denver, CO 80209 |
Second Address | Denver, CO 80209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 08/07/2007 |