Provider Demographics
NPI:1700513850
Name:FOSSE, KENDALL BARBARA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:BARBARA
Last Name:FOSSE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3647 N CLAY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-2831
Mailing Address - Country:US
Mailing Address - Phone:303-995-5583
Mailing Address - Fax:
Practice Address - Street 1:315 W SOUTH BOULDER RD STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1157
Practice Address - Country:US
Practice Address - Phone:303-666-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist