Individual
ELIZABETH FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
8540 SCARBOROUGH DR STE 200, COLORADO SPRINGS, CO 80920-7513
(915) 799-9594
Mailing address
8540 SCARBOROUGH DR STE 200, COLORADO SPRINGS, CO 80920-7513
(915) 799-9594
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0012864
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012864
PHYSICAL THERAPIST ASSISTANT
CO
Enumeration date
05/13/2014
Last updated
05/13/2014
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