Individual
MS. HALLIE DOMANI ATENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2423 COORS DR, GOLDEN, CO 80401-2168
(303) 956-5312
Mailing address
2423 COORS DR, GOLDEN, CO 80401-2168
(303) 956-5312
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PTA0013578
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA0013678
PTA CERTIFICATION
CO
Enumeration date
09/30/2015
Last updated
09/30/2015
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