Provider Demographics
NPI:1922260744
Name:BLEW, KRISTIAN MARTIN (PT DPT)
Entity Type:Individual
Prefix:DR
First Name:KRISTIAN
Middle Name:MARTIN
Last Name:BLEW
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 1:8301 E IOWA DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2705
Mailing Address - Country:US
Mailing Address - Phone:720-748-1930
Mailing Address - Fax:
Practice Address - Street 1:2955 E 1ST AVE
Practice Address - Street 2:SUITE 200 LOWER LEVEL
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5636
Practice Address - Country:US
Practice Address - Phone:303-999-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9767225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist