Provider Demographics
NPI:1043312846
Name:REGAN-REED, KEELIN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KEELIN
Middle Name:
Last Name:REGAN-REED
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3536 FOXTAIL PLACE
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503
Mailing Address - Country:US
Mailing Address - Phone:720-204-6546
Mailing Address - Fax:720-880-3131
Practice Address - Street 1:600 S. AIRPORT RD. ALIGN PT
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503
Practice Address - Country:US
Practice Address - Phone:720-204-6546
Practice Address - Fax:720-880-3131
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2700225100000X
CO0015206225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH08Y003353NH03OtherANTHEM
NH224942OtherCIGNA
NH2700OtherLICENSE
NH2700OtherLICENSE