Individual
HEIDI CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2990 S LIPAN ST, #51, ENGLEWOOD, CO 80110-1478
(303) 895-8648
Mailing address
2990 S LIPAN ST, #51, ENGLEWOOD, CO 80110-1478
(303) 895-8648
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
12388
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12388
MEDICARE
CO
Enumeration date
08/09/2013
Last updated
08/09/2013
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