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General NPI Number Information
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NPI Number | 1902128549
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Entity Type | Individual
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Provider Name | ROSEMARY R. HATFIELD PTA
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Gender | Female
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Dates
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Enumeration Date | 02/24/2010
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Last Update Date | 02/24/2010
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Provider Practice Location Address
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Address Line | 175 CLOVER DRIVE
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City | BAYFIELD
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State | CO
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Zip | 81122
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Country | US
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Telephone | 970-946-9764
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Fax |
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Provider Business Mailing Address
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Address Line | 8309 COUNTY ROAD 510
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City | BAYFIELD
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State | CO
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Zip | 81122-8003
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Country | US
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Telephone | 970-946-9764
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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 | A-0458
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License Number State | NM
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