Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 9656 | CO |
NPI | 1245739663 |
---|---|
Provider Name | Kristin Schank |
First Address | Colorado Springs, CO 80904-2517 |
Second Address | Colorado Springs, CO 80904-2517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2018 |
Last Update Date | 12/02/2018 |