MEDICARE: MRS. GAIL L AUSBUN MS, RKT, NCTMB, CSSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	226300000X	Kinesiotherapist	1484	IL

General Provider Information

NPI Number	:	1699859363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GAIL L AUSBUN MS, RKT, NCTMB, CSSC

Provider Business Mailing Address
First Line	:	613 S IVY WAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80224-1208
Country	:	US
Telephone Number	:	303-807-6816
Fax Number	:

Provider Business Practice Location Address
First Line	:	613 S IVY WAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80224-1208
Country	:	US
Telephone Number	:	303-807-6816
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/08/2007

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