Healthcare Provider Details

I. General information

NPI: 1245909191
Provider Name (Legal Business Name): JOY MICHELLE KITSMILLER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 E FLORIDA AVE STE 917
DENVER CO
80210-2549
US

IV. Provider business mailing address

3716 CHIA DR
COLORADO SPRINGS CO
80925-1379
US

V. Phone/Fax

Practice location:
  • Phone: 844-757-7450
  • Fax:
Mailing address:
  • Phone: 407-718-8976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT37673
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0017912
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: