Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | #362 | NE |
NPI | 1326329061 |
---|---|
Provider Name | Mr. Robert Joseph Killorin |
First Address | Westminster, CO 80021 |
Second Address | Imperial, NE 69033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2011 |
Last Update Date | 08/09/2011 |