Hallie Domani Atencio, PTA
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Golden, CO
NPI 1144690389 · NPPES record last updated Sep 30, 2015
Key facts
- NPI
- 1144690389
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- PTA0013578 (CO)
- Practice address
- 2423 Coors Dr
Golden, CO 80401-2168 - Phone
- (303) 956-5312
- NPI assigned
- Sep 30, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA0013578 | CO | MD | Physical Medicine & Rehabilitation Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | PTA0013578 | CO | Yes |
Addresses
Primary practice location
2423 Coors Dr
Golden, CO 80401-2168
Mailing address
2423 Coors Dr
Golden, CO 80401-2168
Phone (303) 956-5312
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PTA0013678 | Other | CO | PTA CERTIFICATION |
Other providers in Golden, CO
- Sanjay K Arora
- Arrow Mentoring LLC
- Katherine Dianne Arthur
- Ascent Physical Medicine & Rehabilitation, PLLC
- Aspen Medical Massage LLC
- Catherine Fallert Atkinson
- Leigh Atkinson
- Attuned Psychology, LLC
- Leslie Michelle Auer
- Arthur Charles Aughey
All providers in Golden, CO · Physical Medicine & Rehabilitation Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.