Healthcare Provider Details

I. General information

NPI: 1992332019
Provider Name (Legal Business Name): KAROLINA PAULSEN LAT, ATC, CPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 10/24/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 ROXBURY CIR
COLORADO SPRINGS CO
80906-7233
US

IV. Provider business mailing address

335 ROXBURY CIR
COLORADO SPRINGS CO
80906-7233
US

V. Phone/Fax

Practice location:
  • Phone: 719-306-5225
  • Fax:
Mailing address:
  • Phone: 719-306-5225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: