Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PTL0016728 | CO |
N | 2251X0800X | Physical Therapist - Orthopedic | PTL0016728 | CO |
NPI | 1043858251 |
---|---|
Provider Name | Kristen Mcfarland |
First Address | Berthoud, CO 80513-2319 |
Second Address | Berthoud, CO 80534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2019 |
Last Update Date | 18/12/2019 |