Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 5038 | CO |
NPI | 1396916797 |
---|---|
Provider Name | Stephanie Somes |
First Address | Louisville, CO 80027-9731 |
Second Address | Louisville, CO 80027-9731 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2008 |
Last Update Date | 13/03/2008 |