| NPI | 1164785663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY RENAE WILSON Owner/Manager/Otr 719-641-5993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XL0004X Occupational Therapist, Low Vision (Licence: CO 3055) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2012-06-19 |