Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | PTA-0988 | WY |
Y | 213ES0000X | Sports Medicine | PTA-0988 | WY |
NPI | 1386288991 |
---|---|
Provider Name | Morgan Espino |
First Address | Rawlins, WY 82301-5335 |
Second Address | Rawlins, WY 82301-5335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2019 |
Last Update Date | 06/11/2019 |