Healthcare Provider Details

I. General information

NPI: 1457511198
Provider Name (Legal Business Name): GAYLE KLINGLER C.O.T.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 E ILIFF AVE
DENVER CO
80222-5721
US

IV. Provider business mailing address

6060 E ILIFF AVE
DENVER CO
80222-5721
US

V. Phone/Fax

Practice location:
  • Phone: 303-759-4221
  • Fax: 303-745-1345
Mailing address:
  • Phone: 303-759-4221
  • Fax: 303-745-1345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number1154
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: