MEDICARE: ROBYN KADEL ATC, CSCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	AT.0000889	CO

General Provider Information

NPI Number	:	1528478633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBYN KADEL ATC, CSCS

Provider Business Mailing Address
First Line	:	110 GRINNELL ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80911-2216
Country	:	US
Telephone Number	:	719-650-3951
Fax Number	:	719-389-6993

Provider Business Practice Location Address
First Line	:	14 E CACHE LA POUDRE ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-3243
Country	:	US
Telephone Number	:	719-389-6154
Fax Number	:	719-389-6993

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2014
Last Update Date	:	04/29/2014

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