Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 14-02877 | KS |
NPI | 1003285230 |
---|---|
Provider Name | Kathryn Wessel |
First Address | Colorado Springs, CO 80925-1418 |
Second Address | Fort Carson, CO 80913-4613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2015 |
Last Update Date | 11/03/2021 |