Provider Demographics
NPI:1972013886
Name:DOYLE, KARINA MARIE (ATC, LAT, LMT)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:MARIE
Last Name:DOYLE
Suffix:
Gender:F
Credentials:ATC, LAT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 BAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-2111
Mailing Address - Country:US
Mailing Address - Phone:720-652-9873
Mailing Address - Fax:720-652-9873
Practice Address - Street 1:36 BAYLOR DR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-2111
Practice Address - Country:US
Practice Address - Phone:720-652-9873
Practice Address - Fax:720-652-9873
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0019804225700000X
COAT.00016382255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist