Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 3511257 | CO |
NPI | 1043335656 |
---|---|
Provider Name | Mrs. Jean Allyn Dhority |
First Address | Elizabeth, CO 80107-8547 |
Second Address | Elizabeth, CO 80107-8547 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |