Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 8499 | CO |
Y | 2251X0800X | Physical Therapist - Orthopedic | 8499 | CO |
NPI | 1043558935 |
---|---|
Provider Name | Rebecca Story Dunbar |
First Address | Colorado Springs, CO 80962-3113 |
Second Address | Monument, CO 80132-8670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2013 |
Last Update Date | 24/10/2013 |