Individual
MRS. CAROLYN DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
611 N NEVADA AVE, SUITE 3, COLORADO SPRINGS, CO 80903-1099
(719) 229-9235
(719) 447-9262
Mailing address
611 N NEVADA AVE, SUITE 3, COLORADO SPRINGS, CO 80903-1099
(719) 229-9235
(719) 447-9262
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1335
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045617-00
NCTMB #
CO
01
—
1335
STATE OF COLORADO, DEPT OF REGULARTORY AGENCIES, DIVISION OF REGISTRATIONS
CO
Enumeration date
11/22/2006
Last updated
04/08/2009
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