Provider Demographics
NPI:1275843997
Name:PERSHING, KATHRYN P (DPT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:P
Last Name:PERSHING
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 1:7622 MCLAUGHLIN ROAD
Mailing Address - Street 2:
Mailing Address - City:FALCON
Mailing Address - State:CO
Mailing Address - Zip Code:80831
Mailing Address - Country:US
Mailing Address - Phone:719-495-3133
Mailing Address - Fax:719-495-8685
Practice Address - Street 1:7622 MCLAUGHLIN ROAD
Practice Address - Street 2:
Practice Address - City:FALCON
Practice Address - State:CO
Practice Address - Zip Code:80831
Practice Address - Country:US
Practice Address - Phone:719-495-3133
Practice Address - Fax:719-495-8685
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11033225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist