Provider Demographics
NPI:1285326801
Name:GRUMSKI, KENADI MIRANDA (DPT)
Entity type:Individual
Prefix:
First Name:KENADI
Middle Name:MIRANDA
Last Name:GRUMSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9310 BELLCOVE CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7366
Mailing Address - Country:US
Mailing Address - Phone:724-417-8045
Mailing Address - Fax:
Practice Address - Street 1:6385 CORPORATE DR STE 307
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-5913
Practice Address - Country:US
Practice Address - Phone:719-219-9795
Practice Address - Fax:719-219-9695
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT40215225100000X
COMSPTL.0000032225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist