Healthcare Provider Details

I. General information

NPI: 1356555106
Provider Name (Legal Business Name): KARI SHANKS HALL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7935 E PRENTICE AVE SUITE 104
GREENWOOD VILLAGE CO
80111-2708
US

IV. Provider business mailing address

7935 E PRENTICE AVE SUITE 104
GREENWOOD VILLAGE CO
80111-2708
US

V. Phone/Fax

Practice location:
  • Phone: 303-756-0280
  • Fax: 303-756-6059
Mailing address:
  • Phone: 303-756-0280
  • Fax: 303-756-6059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KARI SHANKS HALL
Title or Position: OWNER
Credential: OT
Phone: 303-756-0280