Healthcare Provider Details

I. General information

NPI: 1780758540
Provider Name (Legal Business Name): KERI L KOBAL PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KERI L FRANCIS PT

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 GOLDEN RIDGE RD STE 130
GOLDEN CO
80401-9541
US

IV. Provider business mailing address

660 GOLDEN RIDGE RD STE 130
GOLDEN CO
80401-9541
US

V. Phone/Fax

Practice location:
  • Phone: 303-275-2190
  • Fax: 720-497-6767
Mailing address:
  • Phone: 303-275-2190
  • Fax: 720-497-6767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13648
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: