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General NPI Number Information
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NPI Number | 1437905858
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Entity Type | Individual
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Provider Name | ALICIA MARIE HERNANDEZ DPT
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Gender | Female
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Dates
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Enumeration Date | 04/26/2024
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 117 S ELIZABETH ST
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City | ELIZABETH
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State | CO
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Zip | 80107-7598
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Country | US
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Telephone | 303-646-1445
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Fax | 719-471-4415
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Provider Business Mailing Address
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Address Line | 7622 MCLAUGHLIN RD
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City | PEYTON
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State | CO
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Zip | 80831-4710
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Country | US
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Telephone | 719-495-3133
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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 | 9393
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License Number State | CO
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