Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 1038 | CO |
N | 124Q00000X | Dental Hygienist | 2902002429 | MI |
NPI | 1033501457 |
---|---|
Provider Name | Ms. Linda Gerwatowski |
First Address | Colorado Springs, CO 80919-1018 |
Second Address | Colorado Springs, CO 80919-1018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2015 |
Last Update Date | 22/02/2015 |