Provider Demographics
NPI:1457332124
Name:BARRY, KIMBERLY A (PT)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:A
Last Name:BARRY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9195 GRANT ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4385
Mailing Address - Country:US
Mailing Address - Phone:303-451-7700
Mailing Address - Fax:303-252-9474
Practice Address - Street 1:9195 GRANT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4385
Practice Address - Country:US
Practice Address - Phone:303-451-7700
Practice Address - Fax:303-252-9474
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5988225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist