Healthcare Provider Details

I. General information

NPI: 1184740250
Provider Name (Legal Business Name): KYLE ZIMMERMAN GEBHART MT-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 W OXFORD AVE
DENVER CO
80236-3108
US

IV. Provider business mailing address

1143 WASHINGTON ST APT B
DENVER CO
80203-2644
US

V. Phone/Fax

Practice location:
  • Phone: 303-866-7737
  • Fax:
Mailing address:
  • Phone: 303-478-5919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number07129
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: