Individual
MACIE HAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
417 E KIOWA ST UNIT 307, COLORADO SPRINGS, CO 80903-3494
(512) 876-9692
Mailing address
417 E KIOWA ST UNIT 307, COLORADO SPRINGS, CO 80903-3494
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0014031
CO
Other
Enumeration date
01/12/2017
Last updated
01/12/2017
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