Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | DR-50353 | CO |
NPI | 1003010802 |
---|---|
Provider Name | Dr. Rebecca Marie Bierden |
First Address | Granby, CO 80446-8808 |
Second Address | Johnstown, CO 80534-2800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2007 |
Last Update Date | 22/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
80914333 | (05) | CO |