Basic Information
| Provider Information | |||||||||
| NPI: | 1780815969 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRAMER | ||||||||
| FirstName: | CARIN | ||||||||
| MiddleName: | SOMER BOUCHER | ||||||||
| NamePrefix: | |||||||||
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| Credential: | P.T. | ||||||||
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| OtherLastName: | BOUCHER | ||||||||
| OtherFirstName: | CARIN | ||||||||
| OtherMiddleName: | SOMER | ||||||||
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| OtherCredential: | P.T. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7310 S ALTON WAY | ||||||||
| Address2: | SUITEL 6L | ||||||||
| City: | CENTENNIAL | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801122334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036883914 | ||||||||
| FaxNumber: | 3036884499 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 CASTLETON RD | ||||||||
| Address2: | #100 | ||||||||
| City: | CASTLE ROCK | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801097552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036883914 | ||||||||
| FaxNumber: | 3036884499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2009 | ||||||||
| LastUpdateDate: | 09/16/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT 8656 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.