Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 3073 | CO |
N | 2251E1200X | Ergonomics | 3073 | CO |
N | 225XE1200X | Ergonomics | 3073 | CO |
N | 2251G0304X | Physical Therapist - Geriatrics | 3073 | CO |
N | 2251H1200X | Hand | 3073 | CO |
N | 2251N0400X | Physical Therapist - Neurology | 3073 | CO |
N | 2251S0007X | Physical Therapist - Sports | 3073 | CO |
N | 2251X0800X | Physical Therapist - Orthopedic | 3073 | CO |
NPI | 1184793820 |
---|---|
Provider Name | Dr. Nancy Ford Mulligan |
First Address | Boulder, CO 80303-2699 |
Second Address | Boulder, CO 80303-2699 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 15/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C811082 | MEDICARE PIN (01) | CO |