Provider Demographics
NPI:1821582966
Name:SCHMIDT, LENA KANG (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LENA
Middle Name:KANG
Last Name:SCHMIDT
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 1:6640 FERN DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-2645
Mailing Address - Country:US
Mailing Address - Phone:719-659-9065
Mailing Address - Fax:
Practice Address - Street 1:3441 TENNYSON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-1723
Practice Address - Country:US
Practice Address - Phone:303-941-0664
Practice Address - Fax:303-997-4832
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0015565225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist