Provider Demographics
NPI:1851918759
Name:KLINGENMEIER, KEVIN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:KLINGENMEIER
Suffix:
Gender:M
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 1:275 CENTURY CIR STE 103
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9453
Mailing Address - Country:US
Mailing Address - Phone:303-926-1444
Mailing Address - Fax:303-926-0038
Practice Address - Street 1:275 CENTURY CIR STE 103
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9453
Practice Address - Country:US
Practice Address - Phone:303-926-1444
Practice Address - Fax:303-926-0038
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17034225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist