Individual
CAROL MARGARET FUSTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1919 68TH AVE, GREELEY, CO 80634-8061
(970) 350-5155
Mailing address
309 S WHITCOMB ST, FORT COLLINS, CO 80521-2643
(719) 924-4650
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL.0002454
CO
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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