Organization
MISA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA SEVILLA MA, OTR (PRESIDENT)
(303) 249-3099
Entity
Organization
Contact information
Practice address
8206 E 28TH DR, DENVER, CO 80238-2516
(303) 249-3099
Mailing address
8206 E 28TH DR, DENVER, CO 80238-2516
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65476727
—
CO
Enumeration date
05/10/2007
Last updated
07/07/2015
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