Healthcare Provider Details

I. General information

NPI: 1861301228
Provider Name (Legal Business Name): KINLEY ORR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 S BLACKHAWK ST STE 240
AURORA CO
80014-1475
US

IV. Provider business mailing address

15045 E LOUISIANA DR UNIT B
AURORA CO
80012-7760
US

V. Phone/Fax

Practice location:
  • Phone: 720-505-3587
  • Fax:
Mailing address:
  • Phone: 802-359-2189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0026382
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: