Provider Demographics
NPI:1841855137
Name:KOCIAN, KALI LAUREN
Entity type:Individual
Prefix:
First Name:KALI
Middle Name:LAUREN
Last Name:KOCIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 SUNDANCE PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2779
Mailing Address - Country:US
Mailing Address - Phone:830-625-6700
Mailing Address - Fax:
Practice Address - Street 1:1002 FOREST DR
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-2918
Practice Address - Country:US
Practice Address - Phone:307-856-9471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1314873225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist