Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PTA.0014188 | CO |
NPI | 1033636022 |
---|---|
Provider Name | Daniel Taylor Maxwell |
First Address | Thornton, CO 80229-5311 |
Second Address | Thornton, CO 80229-5311 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2017 |
Last Update Date | 29/08/2017 |