Provider Demographics
NPI:1801843594
Name:KEIRNS, MICHAEL ARLIE (DPT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ARLIE
Last Name:KEIRNS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7310 S ALTON WAY
Mailing Address - Street 2:#6L
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2334
Mailing Address - Country:US
Mailing Address - Phone:303-790-4495
Mailing Address - Fax:720-488-1988
Practice Address - Street 1:5801 S QUEBEC ST
Practice Address - Street 2:#100
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2003
Practice Address - Country:US
Practice Address - Phone:303-694-9193
Practice Address - Fax:303-779-0566
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO1927225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPENDINGMedicare PIN