Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 9811000162 |
NPI | 1003855115 |
---|---|
Provider Name | Mrs. Ann T. King |
First Address | Colorado Springs, CO 80906-7644 |
Second Address | Peyton, CO 80831-4710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 15/09/2015 |