Provider Demographics
NPI:1023386661
Name:SIKORA, KIM ANNE (ATC)
Entity Type:Individual
Prefix:MS
First Name:KIM
Middle Name:ANNE
Last Name:SIKORA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19763 E 55TH PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-7568
Mailing Address - Country:US
Mailing Address - Phone:908-295-1926
Mailing Address - Fax:
Practice Address - Street 1:19763 E 55TH PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-7568
Practice Address - Country:US
Practice Address - Phone:908-295-1926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-11
Last Update Date:2011-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer