Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 299129 | CA |
Y | 225100000X | Physical Therapist | PTL0017605 | CO |
NPI | 1063092732 |
---|---|
Provider Name | Korin Cuico |
First Address | Carson, CA 90745-2533 |
Second Address | Northglenn, CO 80233-1100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2021 |
Last Update Date | 08/10/2021 |