Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 6833 | CO |
NPI | 1053979468 |
---|---|
Provider Name | Karin Morton |
First Address | Denver, CO 80238-2980 |
Second Address | Denver, CO 80238-2980 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2019 |
Last Update Date | 24/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6833 | DORA PT LICENSE (01) | CO |