Provider Demographics
NPI:1477834059
Name:BYRNE, KRISTIN NOEL (MPT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NOEL
Last Name:BYRNE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 ESTES CT
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:CO
Mailing Address - Zip Code:80540-3803
Mailing Address - Country:US
Mailing Address - Phone:303-823-7405
Mailing Address - Fax:303-823-7405
Practice Address - Street 1:107 ESTES CT
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:CO
Practice Address - Zip Code:80540-3803
Practice Address - Country:US
Practice Address - Phone:303-823-7405
Practice Address - Fax:303-823-7405
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8494225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic