Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 0013767 | CO |
NPI | 1083072243 |
---|---|
Provider Name | Heather Markus |
First Address | Longmont, CO 80501-6559 |
Second Address | Longmont, CO 80501-6559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2016 |
Last Update Date | 03/02/2016 |