Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 0013256 | CO |
NPI | 1003295346 |
---|---|
Provider Name | Karen Bishop |
First Address | Plattsmouth, NE 68048-2146 |
Second Address | Pueblo, CO 81008-1667 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2015 |
Last Update Date | 19/05/2015 |