Provider Demographics
NPI:1356452536
Name:KAISER, MICHELLE N (OTR)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:N
Last Name:KAISER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22811 COUNTY ROAD 36
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-9207
Mailing Address - Country:US
Mailing Address - Phone:970-522-0611
Mailing Address - Fax:970-522-7990
Practice Address - Street 1:22811 COUNTY ROAD 36
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-9207
Practice Address - Country:US
Practice Address - Phone:970-522-0611
Practice Address - Fax:970-522-7990
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO995958208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01834223Medicaid