Healthcare Provider Details

I. General information

NPI: 1467807149
Provider Name (Legal Business Name): DAVID KINGS OGINNI PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2016
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR # B7500
FORT CARSON CO
80913-4613
US

IV. Provider business mailing address

1650 COCHRANE CIR # B7500
FORT CARSON CO
80913-4613
US

V. Phone/Fax

Practice location:
  • Phone: 719-503-7487
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1304607
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2119871
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: