Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | ||
N | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1588956841 |
---|---|
Provider Name | Mr. William G Westergard |
First Address | Evergreen, CO 80439-7460 |
Second Address | Lakewood, CO 80226-3544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2011 |
Last Update Date | 05/05/2011 |