Provider Demographics
NPI:1780758540
Name:KOBAL, KERI L (PT)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:L
Last Name:KOBAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:L
Other - Last Name:FRANCIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:660 GOLDEN RIDGE RD STE 130
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-9541
Mailing Address - Country:US
Mailing Address - Phone:303-275-2190
Mailing Address - Fax:720-497-6767
Practice Address - Street 1:660 GOLDEN RIDGE RD STE 130
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-9541
Practice Address - Country:US
Practice Address - Phone:303-275-2190
Practice Address - Fax:720-497-6767
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CO13648225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OPT296291Medicare UPIN
ZZZ258532Medicare ID - Type Unspecified