Provider Demographics
NPI:1780176735
Name:KIDS CAN
Entity type:Organization
Organization Name:KIDS CAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:MCCAIN
Authorized Official - Last Name:REINTSEMA
Authorized Official - Suffix:
Authorized Official - Credentials:BA PT
Authorized Official - Phone:303-499-1322
Mailing Address - Street 1:960 55TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2954
Mailing Address - Country:US
Mailing Address - Phone:303-499-1322
Mailing Address - Fax:
Practice Address - Street 1:960 55TH ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2954
Practice Address - Country:US
Practice Address - Phone:303-499-1322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO27052251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty