Healthcare Provider Details

I. General information

NPI: 1568039857
Provider Name (Legal Business Name): STEPHANIE CHRISTINE KUTCHER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2021
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 W 13TH AVE APT 138
LAKEWOOD CO
80214-4781
US

IV. Provider business mailing address

1185 S BEECH DR APT 203
LAKEWOOD CO
80228-3439
US

V. Phone/Fax

Practice location:
  • Phone: 303-770-4682
  • Fax:
Mailing address:
  • Phone: 805-404-7202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0017723
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: