Provider Demographics
NPI:1699192112
Name:KITCHENER, TANICE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:TANICE
Middle Name:
Last Name:KITCHENER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19482 E IOWA CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-4611
Mailing Address - Country:US
Mailing Address - Phone:303-507-9561
Mailing Address - Fax:
Practice Address - Street 1:19482 E IOWA CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-4611
Practice Address - Country:US
Practice Address - Phone:303-507-9561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10169208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation