Provider Demographics
NPI:1770622326
Name:DEINES, KATHERINE M (PT, DPT, NCS)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:M
Last Name:DEINES
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8033 S RACE WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-3217
Mailing Address - Country:US
Mailing Address - Phone:303-909-6007
Mailing Address - Fax:303-738-5544
Practice Address - Street 1:8033 S RACE WAY
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-3217
Practice Address - Country:US
Practice Address - Phone:303-909-6007
Practice Address - Fax:303-738-5544
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO41384Medicare PIN
COC535958Medicare ID - Type Unspecified