Individual
MIRANDA GOEDTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5775 N UNION BLVD, COLORADO SPRINGS, CO 80918-1744
(719) 434-7044
Mailing address
2450 MOUNTAIN PINE LN, COLORADO SPRINGS, CO 80921-2007
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8363
TN
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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