Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 3898 |
NPI | 1124362660 |
---|---|
Provider Name | Marta C Gulezian |
First Address | Denver, CO 80207-3839 |
Second Address | Denver, CO 80207-3839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2012 |
Last Update Date | 09/06/2020 |