Provider Demographics
NPI:1164479333
Name:KITTLES, CHRISTINE M (MSPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:KITTLES
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:M
Other - Last Name:PAWLAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:6979 S HOLLY CIR
Mailing Address - Street 2:STE 105
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1577
Mailing Address - Country:US
Mailing Address - Phone:303-694-2295
Mailing Address - Fax:303-694-1843
Practice Address - Street 1:50 S STEELE ST
Practice Address - Street 2:STE 550
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2805
Practice Address - Country:US
Practice Address - Phone:303-393-6533
Practice Address - Fax:303-393-7846
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8627225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO066600Medicare Oscar/Certification