Basic Information
| Provider Information | |||||||||
| NPI: | 1841663952 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAUNEY | ||||||||
| FirstName: | KAITLIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1234 WHITEFISH STAGE | ||||||||
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| City: | KALISPELL | ||||||||
| State: | MT | ||||||||
| PostalCode: | 599012753 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 8 W DRY CREEK CIR STE 130 | ||||||||
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| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801204477 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039558163 | ||||||||
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| ProviderEnumerationDate: | 11/11/2015 | ||||||||
| LastUpdateDate: | 11/11/2015 | ||||||||
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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 | PTL0013326 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.