Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 0014799 | CO |
NPI | 1073106142 |
---|---|
Provider Name | Ryan Mueller |
First Address | Colorado Springs, CO 80916-2067 |
Second Address | Colorado Springs, CO 80916-2067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2021 |
Last Update Date | 18/02/2021 |