Provider Demographics
NPI:1831638485
Name:KASPIN, MIKHAIL
Entity Type:Individual
Prefix:
First Name:MIKHAIL
Middle Name:
Last Name:KASPIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:KASPIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:13170 E LINVALE PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3431
Mailing Address - Country:US
Mailing Address - Phone:720-219-8146
Mailing Address - Fax:
Practice Address - Street 1:6795 E TENNESSEE AVE STE 100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1616
Practice Address - Country:US
Practice Address - Phone:720-219-8146
Practice Address - Fax:720-219-8146
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-15
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014516225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist