Mary Kim Tadda

NPI #1174157564 in Evergreen, Colorado

Provider Information

NPI Number: 1174157564
Entity Type: Individual
Name: Mary Kim Tadda
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Feb 25, 2020
Last Updated: Feb 25, 2020

Practice Location

Address: 30940 STAGECOACH BLVD # 110
City: Evergreen
State: Colorado
ZIP Code: 80439-7984
Phone: (303) 674-1594

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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