Provider Demographics
NPI:1962046417
Name:CHURA, CLARE (OTR/L)
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:CHURA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6130 W 40TH AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-5059
Mailing Address - Country:US
Mailing Address - Phone:321-443-9256
Mailing Address - Fax:
Practice Address - Street 1:8540 SCARBOROUGH DR STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7513
Practice Address - Country:US
Practice Address - Phone:719-632-8325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0006174225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist