Provider Demographics
NPI:1124544119
Name:ADLER, AVELENE KI-CHI CHAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:AVELENE
Middle Name:KI-CHI CHAN
Last Name:ADLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:AVELENE
Other - Middle Name:KI-CHI
Other - Last Name:CHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7395 W EASTMAN PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5006
Mailing Address - Country:US
Mailing Address - Phone:720-838-2909
Mailing Address - Fax:
Practice Address - Street 1:7395 W EASTMAN PL
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5006
Practice Address - Country:US
Practice Address - Phone:720-838-2909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CO0014944225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist