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General NPI Number Information
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NPI Number | 1972847549
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Entity Type | Individual
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Provider Name | CATHERINE ANN WILT BS
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Gender | Female
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Dates
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Enumeration Date | 11/20/2012
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Last Update Date | 11/20/2012
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Provider Practice Location Address
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Address Line | 1338 PHAY AVENUE
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City | CANON CITY
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State | CO
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Zip | 81212-2302
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Country | US
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Telephone | 719-285-2609
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Fax | 719-285-2600
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Provider Business Mailing Address
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Address Line | 1338 PHAY AVENUE
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City | CANON CITY
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State | CO
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Zip | 81212-2302
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Country | US
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Telephone | 719-285-2609
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Fax | 719-285-2600
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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 | 7689
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License Number State | CO
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