Provider Demographics
NPI:1396357190
Name:CABLE, KAYLA (ATC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:CABLE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:CZARNEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:16647 E HIALEAH AVE
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-4101
Mailing Address - Country:US
Mailing Address - Phone:303-521-8798
Mailing Address - Fax:
Practice Address - Street 1:16100 E SMOKY HILL RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1751
Practice Address - Country:US
Practice Address - Phone:720-886-5657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAT.00016352255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer