Healthcare Provider Details

I. General information

NPI: 1821582966
Provider Name (Legal Business Name): LENA KANG SCHMIDT PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2018
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3441 TENNYSON ST
DENVER CO
80212-1723
US

IV. Provider business mailing address

6640 FERN DR
DENVER CO
80221-2645
US

V. Phone/Fax

Practice location:
  • Phone: 303-941-0664
  • Fax: 303-997-4832
Mailing address:
  • Phone: 719-659-9065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0015565
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: