Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PTL-0005854 | CO |
NPI | 1043756737 |
---|---|
Provider Name | Kara Pontius |
First Address | Highlands Ranch, CO 80126-2684 |
Second Address | Highlands Ranch, CO 80126-2684 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2017 |
Last Update Date | 18/01/2017 |