Healthcare Provider Details

I. General information

NPI: 1396037669
Provider Name (Legal Business Name): PAULA NOREEN MISCHLICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2011
Last Update Date: 05/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MOUNT SOPRIS DR
GLENWOOD SPRINGS CO
81601-4622
US

IV. Provider business mailing address

700 MOUNT SOPRIS DRIVE
GLENWOOD SPRINGS CO
81601
US

V. Phone/Fax

Practice location:
  • Phone: 970-945-2306
  • Fax: 970-945-6469
Mailing address:
  • Phone: 970-945-2306
  • Fax: 970-945-6469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: