Provider Demographics
NPI:1639466378
Name:KULP, KATHERINE DIANE (DPT)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:DIANE
Last Name:KULP
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 1:1070 VINE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2920
Mailing Address - Country:US
Mailing Address - Phone:303-667-5921
Mailing Address - Fax:
Practice Address - Street 1:1070 VINE ST APT 2
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-2920
Practice Address - Country:US
Practice Address - Phone:303-667-5921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11271225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist