Provider Demographics
NPI:1831138163
Name:ABERNATHY, MARY KATHRYN (MSPT)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:KATHRYN
Last Name:ABERNATHY
Suffix:
Gender:F
Credentials:MSPT
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Mailing Address - Street 1:5200 S ULSTER ST
Mailing Address - Street 2:#1420
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2861
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8200 E BELLEVIEW AVE
Practice Address - Street 2:SUITE 428C
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2803
Practice Address - Country:US
Practice Address - Phone:303-741-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2009-10-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO6853225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO804164Medicare UPIN