Individual
ELIDE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10076 SEDALIA ST, COMMERCE CITY, CO 80022-8744
(323) 472-0408
Mailing address
10076 SEDALIA ST, COMMERCE CITY, CO 80022-8744
(323) 472-0408
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0014819
CO
Other
Enumeration date
12/15/2020
Last updated
12/16/2020
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