Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 32707 | CO |
NPI | 1124083647 |
---|---|
Provider Name | Debra B Conforti |
First Address | Aurora, CO 80012-6165 |
Second Address | Thornton, CO 80229-4358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 09/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32707 | STATE ID (01) | CO |