Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 3417 | CO |
NPI | 1003009028 |
---|---|
Provider Name | Miss Catherine Mary Zimmer |
First Address | Carbondale, CO 81623-1850 |
Second Address | Carbondale, CO 81623-1850 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2007 |
Last Update Date | 22/08/2007 |