Healthcare Provider Details

I. General information

NPI: 1124139258
Provider Name (Legal Business Name): KATHY JANE KOOP DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 S ONEIDA ST STE 302
DENVER CO
80224-2559
US

IV. Provider business mailing address

2250 S ONEIDA ST STE 302
DENVER CO
80224-2559
US

V. Phone/Fax

Practice location:
  • Phone: 303-758-6400
  • Fax: 303-759-1276
Mailing address:
  • Phone: 303-758-6400
  • Fax: 303-759-1276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2817
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number2817
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: