Provider Demographics
NPI:1699211219
Name:BAUMAN, KYLIE (PT)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 VIOLET ST
Mailing Address - Street 2:UNIT 150
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-6723
Mailing Address - Country:US
Mailing Address - Phone:303-279-6000
Mailing Address - Fax:303-279-7799
Practice Address - Street 1:251 VIOLET ST
Practice Address - Street 2:UNIT 150
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-6723
Practice Address - Country:US
Practice Address - Phone:303-279-6000
Practice Address - Fax:303-279-7799
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-07
Last Update Date:2017-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.00145172251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic