Provider Demographics
NPI:1134876055
Name:MAYS, KATIE SELLERS
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:SELLERS
Last Name:MAYS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 E CATHEDRAL CT
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:CO
Mailing Address - Zip Code:81647-9488
Mailing Address - Country:US
Mailing Address - Phone:601-596-7993
Mailing Address - Fax:
Practice Address - Street 1:2901 N 12TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-2811
Practice Address - Country:US
Practice Address - Phone:970-243-7211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPTA6610225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant