Provider Demographics
NPI:1780815969
Name:CRAMER, CARIN SOMER BOUCHER (PT)
Entity Type:Individual
Prefix:
First Name:CARIN
Middle Name:SOMER BOUCHER
Last Name:CRAMER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CARIN
Other - Middle Name:SOMER
Other - Last Name:BOUCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7310 S ALTON WAY
Mailing Address - Street 2:SUITEL 6L
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2334
Mailing Address - Country:US
Mailing Address - Phone:303-688-3914
Mailing Address - Fax:303-688-4499
Practice Address - Street 1:900 CASTLETON RD
Practice Address - Street 2:#100
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-7552
Practice Address - Country:US
Practice Address - Phone:303-688-3914
Practice Address - Fax:303-688-4499
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPT 8656225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist