Healthcare Provider Details

I. General information

NPI: 1477215408
Provider Name (Legal Business Name): KAILEY BROOKE GRIFFIN DPT, ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13655 BRONCOS PKWY
CENTENNIAL CO
80112-4150
US

IV. Provider business mailing address

6195 TRANQUIL DESERT DR
EL PASO TX
79912-7496
US

V. Phone/Fax

Practice location:
  • Phone: 303-649-9000
  • Fax:
Mailing address:
  • Phone: 915-471-6020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT.0002903
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: