Provider Demographics
NPI:1609009869
Name:WALSH, KARA LYN (MSPT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:LYN
Last Name:WALSH
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10471 BROOKWOOD PT
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-6893
Mailing Address - Country:US
Mailing Address - Phone:720-524-5604
Mailing Address - Fax:
Practice Address - Street 1:9200 W CROSS DR
Practice Address - Street 2:SUITE 400
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-2239
Practice Address - Country:US
Practice Address - Phone:303-904-8133
Practice Address - Fax:303-904-8109
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC458218Medicare PIN