Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PTL.0013734 | CO |
NPI | 1003280355 |
---|---|
Provider Name | Katie Carbiener |
First Address | Littleton, CO 80127-6423 |
Second Address | Littleton, CO 80127-6423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2015 |
Last Update Date | 24/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PTL.0013734 | PT LICENSE (01) | CO |