Healthcare Provider Details

I. General information

NPI: 1306324652
Provider Name (Legal Business Name): CAITLYN MICHELLE BLUMBERG DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAITLYN KOST

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5008 W 92ND AVE
WESTMINSTER CO
80031-6302
US

IV. Provider business mailing address

5008 W 92ND AVE
WESTMINSTER CO
80031-6302
US

V. Phone/Fax

Practice location:
  • Phone: 303-412-7035
  • Fax: 303-412-7993
Mailing address:
  • Phone: 303-412-7035
  • Fax: 303-412-7993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0019625
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: