Provider Demographics
NPI:1376624692
Name:KASPER, HARALD (PT)
Entity Type:Individual
Prefix:MR
First Name:HARALD
Middle Name:
Last Name:KASPER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:HARALD
Other - Middle Name:
Other - Last Name:KASPER-RIGGIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 2526
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80901-2526
Mailing Address - Country:US
Mailing Address - Phone:800-530-3065
Mailing Address - Fax:800-514-5044
Practice Address - Street 1:233 F ST
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-2103
Practice Address - Country:US
Practice Address - Phone:719-539-6144
Practice Address - Fax:719-539-1411
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5982225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96086599Medicaid
COF6913Medicare PIN