Provider Demographics
NPI:1376264846
Name:GOYA, KAILEE (PTA)
Entity Type:Individual
Prefix:
First Name:KAILEE
Middle Name:
Last Name:GOYA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2916 W LONG CIR APT B
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4340
Mailing Address - Country:US
Mailing Address - Phone:808-753-0043
Mailing Address - Fax:
Practice Address - Street 1:5801 S QUEBEC ST STE 100
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2010
Practice Address - Country:US
Practice Address - Phone:303-770-0870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015224225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant