Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | AT.0001673 | CO |
Y | 213ES0000X | Sports Medicine | AT.0001673 | CO |
NPI | 1437734530 |
---|---|
Provider Name | Erik Marsh |
First Address | Usaf Academy, CO 80840-9599 |
Second Address | Usaf Academy, CO 80840-9599 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2021 |
Last Update Date | 10/03/2021 |