Healthcare Provider Details

I. General information

NPI: 1699189811
Provider Name (Legal Business Name): MARIA MONICA ZAMORA-HARRIS PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MONICA ZAMORA-HARRIS PTA

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 06/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 E ILIFF AVE
DENVER CO
80222-5721
US

IV. Provider business mailing address

2955 GLENWOOD DR APT. 319
BOULDER CO
80301-1317
US

V. Phone/Fax

Practice location:
  • Phone: 303-759-4221
  • Fax:
Mailing address:
  • Phone: 410-802-0907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number0013314
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: