MEDICARE: CARLA ANN HABUDA MPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	5975	CO

General Provider Information

NPI Number	:	1669549382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA ANN HABUDA MPT

Provider Business Mailing Address
First Line	:	3738 E 6TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-4550
Country	:	US
Telephone Number	:	303-333-5856
Fax Number	:

Provider Business Practice Location Address
First Line	:	3738 E 6TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-4550
Country	:	US
Telephone Number	:	303-333-5856
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	07/08/2007

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