Healthcare Provider Details

I. General information

NPI: 1669961793
Provider Name (Legal Business Name): KRISTINA ROSEN MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2018
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5716 AKSARBEN DR
WINDSOR CO
80550-7070
US

IV. Provider business mailing address

4740 W MINERAL AVE APT 301
LITTLETON CO
80128-2623
US

V. Phone/Fax

Practice location:
  • Phone: 970-819-6707
  • Fax:
Mailing address:
  • Phone: 870-612-4458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0018174
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: