Basic Information
| Provider Information | |||||||||
| NPI: | 1003280355 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARBIENER | ||||||||
| FirstName: | KATIE | ||||||||
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| Credential: | P.T., D.P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10268 W CENTENNIAL RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801276423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039482999 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10268 W CENTENNIAL RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801276423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039482999 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2015 | ||||||||
| LastUpdateDate: | 11/24/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PTL.0013734 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | PTL.0013734 | 01 | CO | PT LICENSE | OTHER |