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General NPI Number Information
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NPI Number | 1700509502
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Entity Type | Individual
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Provider Name | HAYLEY KATHLEEN WETZEL
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Gender | Female
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 4500 E CHERRY CREEK SOUTH DR
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City | DENVER
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State | CO
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Zip | 80246-1518
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Country | US
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Telephone | 719-695-4535
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Fax | 855-937-5828
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Provider Business Mailing Address
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Address Line | 4779 GOLDFINCH CT
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City | PUEBLO
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State | CO
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Zip | 81008-1910
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Country | US
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Telephone | 720-232-8437
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 0015251
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License Number State | CO
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