Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | DR.0063852 | CO |
NPI | 1336674936 |
---|---|
Provider Name | Erin Bomberg |
First Address | Steamboat Springs, CO 80488-1029 |
Second Address | Steamboat Springs, CO 80487 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2017 |
Last Update Date | 17/07/2020 |