Individual
MRS. AMY KRISTEN SIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8566
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
805137
MEDICARE GROUP
CO
Enumeration date
05/17/2007
Last updated
03/06/2008
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