Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | MT.0020204 | CO |
NPI | 1275031320 |
---|---|
Provider Name | Moriah Lynn Day |
First Address | Boulder, CO 80304-2483 |
Second Address | Boulder, CO 80304-2433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2018 |
Last Update Date | 11/06/2019 |