Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 8385 | CO |
N | 2251X0800X | Physical Therapist - Orthopedic | 8385 | CO |
NPI | 1083803381 |
---|---|
Provider Name | Dana Lyn Judd |
First Address | Englewood, CO 80110-2476 |
Second Address | Englewood, CO 80110-2476 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2007 |
Last Update Date | 23/10/2007 |