Healthcare Provider Details

I. General information

NPI: 1679499503
Provider Name (Legal Business Name): KAITLYN MILHOLLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 25.5 RD
GRAND JUNCTION CO
81505
US

IV. Provider business mailing address

627 25.5 RD
GRAND JUNCTION CO
81505
US

V. Phone/Fax

Practice location:
  • Phone: 970-683-2225
  • Fax:
Mailing address:
  • Phone: 970-683-2225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number0021342
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: