Individual
MS. PAULETTE KIMBERLY LARUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
6385 CORPORATE DR, COLORADO SPRINGS, CO 80919-5901
(828) 670-8056
(828) 670-8057
Mailing address
6385 CORPORATE DR, COLORADO SPRINGS, CO 80919-5901
(719) 380-1100
(828) 670-8057
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
6284
NC
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
Primary
6284
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079HJ
BCBS
NC
05
—
7211608
—
NC
01
—
9370547
PHCS
—
01
—
D7567
MEDCOST
NC
Enumeration date
02/03/2006
Last updated
10/28/2023
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