Provider Demographics
NPI:1952320624
Name:HAMM, CARRIE DUNLAP (MPT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:DUNLAP
Last Name:HAMM
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2388 BITTERROOT LN
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-9103
Mailing Address - Country:US
Mailing Address - Phone:303-679-9104
Mailing Address - Fax:
Practice Address - Street 1:26659 PLEASANT PARK RD
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-7714
Practice Address - Country:US
Practice Address - Phone:303-838-1970
Practice Address - Fax:303-670-4526
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6850225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCN3083Medicare PIN