Provider Demographics
NPI:1659048668
Name:ESCOBAR, KEVIN D (DPT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:D
Last Name:ESCOBAR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:DANIEL
Other - Last Name:ESCOBAR LASCURAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:600 N GRANT ST STE 208
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3527
Mailing Address - Country:US
Mailing Address - Phone:303-832-5577
Mailing Address - Fax:303-996-0390
Practice Address - Street 1:7821 W 38TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6185
Practice Address - Country:US
Practice Address - Phone:303-955-8091
Practice Address - Fax:303-474-6209
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0017848225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist