Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA.0013533 | CO |
NPI | 1013307529 |
---|---|
Provider Name | Joseph Dunn |
First Address | Lafayette, CO 80026-2839 |
Second Address | Greenwood Village, CO 80111-2905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2015 |
Last Update Date | 04/02/2015 |