Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PTL.0016701 | CO |
NPI | 1093353237 |
---|---|
Provider Name | Tonya Mulkey |
First Address | Littleton, CO 80163-0001 |
Second Address | Denver, CO 80202-6536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2019 |
Last Update Date | 18/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
TBD | (05) | CO |