Basic Information
| Provider Information | |||||||||
| NPI: | 1063872414 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARPENTER | ||||||||
| FirstName: | KRISTEN | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8670 WOLFF CT | ||||||||
| Address2: | #115 | ||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800316956 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 8670 WOLFF CT | ||||||||
| Address2: | #115 | ||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800316956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036501700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2016 | ||||||||
| LastUpdateDate: | 02/27/2016 | ||||||||
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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 | 0010052 | IA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.