Healthcare Provider Details

I. General information

NPI: 1578963229
Provider Name (Legal Business Name): KIDS IN ACTION, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2014
Last Update Date: 08/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3345 CROWLEY CIR
LOVELAND CO
80538-4955
US

IV. Provider business mailing address

3345 CROWLEY CIR
LOVELAND CO
80538-4955
US

V. Phone/Fax

Practice location:
  • Phone: 720-421-7412
  • Fax: 720-554-8058
Mailing address:
  • Phone: 720-421-7412
  • Fax: 720-554-8058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number1439
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1439
License Number StateWY

VIII. Authorized Official

Name: DR. LAUREN ELIZABETH BOGGS
Title or Position: OWNER, PHYSICAL THERAPIST
Credential: DPT
Phone: 720-421-7412