Provider Demographics
NPI:1508268194
Name:KATHRYN DIFRANK
Entity Type:Organization
Organization Name:KATHRYN DIFRANK
Other - Org Name:ENROOT LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:DOROTHY
Authorized Official - Last Name:DIFRANK
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:720-470-0249
Mailing Address - Street 1:PO BOX 983
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-0983
Mailing Address - Country:US
Mailing Address - Phone:720-470-0249
Mailing Address - Fax:
Practice Address - Street 1:652 MELISSA LN
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-2819
Practice Address - Country:US
Practice Address - Phone:720-470-0249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty