Healthcare Provider Details

I. General information

NPI: 1235628207
Provider Name (Legal Business Name): KRISTOPHER JOSEPH LITTEL PT, DPT, LAT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2018
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 IRIS AVE
BOULDER CO
80301-1994
US

IV. Provider business mailing address

3101 IRIS AVE
BOULDER CO
80301-1994
US

V. Phone/Fax

Practice location:
  • Phone: 303-444-5105
  • Fax:
Mailing address:
  • Phone: 303-444-5105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT.0002810
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0020674
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: