Provider Demographics
NPI:1306830112
Name:KOLKMAN, DAWN C (MSPT)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:C
Last Name:KOLKMAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2497 POWER RD UNIT 10
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-3085
Mailing Address - Country:US
Mailing Address - Phone:970-263-4079
Mailing Address - Fax:
Practice Address - Street 1:2497 POWER RD UNIT 10
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81507-3085
Practice Address - Country:US
Practice Address - Phone:970-263-4079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2013-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL 8999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPTL8999OtherPT CO STATE LICENSE
COQ44138Medicare UPIN