Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 12055 |
NPI | 1003424177 |
---|---|
Provider Name | Kirsten J Ronan I |
First Address | Erie, CO 80516-6898 |
Second Address | Brighton, CO 80601-2538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2020 |
Last Update Date | 15/07/2020 |