Individual
MARY THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3090 N ACADEMY BLVD, COLORADO SPRINGS, CO 80917-5310
(719) 574-8300
Mailing address
3090 N ACADEMY BLVD, COLORADO SPRINGS, CO 80917-5310
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0004710
CO
Other
Enumeration date
08/24/2015
Last updated
06/29/2016
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