Individual
ANNIE HOLGERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
409 BENEDICTA AVE, TRINIDAD, CO 81082-2004
(719) 846-9291
Mailing address
409 BENEDICTA AVE, TRINIDAD, CO 81082-2004
(719) 846-9291
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0012197
CO
225200000X
Physical Therapy Assistant
14-02266
KS
Other
Enumeration date
12/16/2014
Last updated
12/16/2014
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