Provider Demographics
NPI:1407624497
Name:WELCH, KRISTA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 S YOSEMITE ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1308
Mailing Address - Country:US
Mailing Address - Phone:303-570-4156
Mailing Address - Fax:
Practice Address - Street 1:608 S CORONA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-4406
Practice Address - Country:US
Practice Address - Phone:303-570-4156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5365225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist