Healthcare Provider Details

I. General information

NPI: 1679265136
Provider Name (Legal Business Name): KAITLYN MERRITT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6851 S HOLLY CIR STE 110
CENTENNIAL CO
80112-1050
US

IV. Provider business mailing address

6851 S HOLLY CIR STE 110
CENTENNIAL CO
80112-1050
US

V. Phone/Fax

Practice location:
  • Phone: 720-641-0181
  • Fax: 720-381-6868
Mailing address:
  • Phone: 720-641-0181
  • Fax: 720-381-6868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0019119
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: