Provider Demographics
NPI:1932414828
Name:KEIGHLEY, KATIE (DPT)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:KEIGHLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 S TELLER ST
Mailing Address - Street 2:SUITE 270
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-7388
Mailing Address - Country:US
Mailing Address - Phone:303-274-2404
Mailing Address - Fax:303-274-2406
Practice Address - Street 1:325 S TELLER ST
Practice Address - Street 2:SUITE 270
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-7388
Practice Address - Country:US
Practice Address - Phone:303-274-2404
Practice Address - Fax:303-274-2406
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10438225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist