Provider Demographics
NPI:1942546494
Name:ANDERSON, KATHRYN ESTELLE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ESTELLE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 E NICHOLS AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3475
Mailing Address - Country:US
Mailing Address - Phone:707-996-1735
Mailing Address - Fax:707-935-8177
Practice Address - Street 1:9000 E NICHOLS AVE
Practice Address - Street 2:STE 201
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3475
Practice Address - Country:US
Practice Address - Phone:707-996-1735
Practice Address - Fax:707-935-8177
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 00000719225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist