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Individual

PAULETT R WENTWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CERTIFIED FITTER

Contact information

Practice address
4419 CENTENNIAL BLVD # 106, COLORADO SPRINGS, CO 80907-3739
(719) 351-8286
(719) 265-9334
Mailing address
4419 CENTENNIAL #106, COLORADO SPRINGS, CO 80907
(719) 351-8286
(719) 265-9334

Taxonomy

Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
CO

Other

Enumeration date
10/10/2006
Last updated
07/08/2007
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