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General NPI Number Information
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NPI Number | 1205177805
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Entity Type | Individual
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Provider Name | AGNES O'ROURKE
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Gender | Female
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Dates
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Enumeration Date | 03/06/2013
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Last Update Date | 11/18/2014
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Provider Practice Location Address
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Address Line | 8670 WOLFF CT STE 115
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City | WESTMINSTER
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State | CO
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Zip | 80031-3692
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Country | US
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Telephone | 720-837-7574
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Fax |
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Provider Business Mailing Address
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Address Line | 6668 WALKER CT
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City | NIWOT
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State | CO
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Zip | 80503-8653
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6238
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License Number State | CO
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