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General NPI Number Information
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NPI Number | 1023629490
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Entity Type | Individual
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Provider Name | JUSTIN KODY
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Gender | Male
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Dates
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Enumeration Date | 08/11/2020
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 175 INVERNESS DR W STE 100
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City | ENGLEWOOD
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State | CO
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Zip | 80112-5066
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Country | US
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Telephone | 303-694-3333
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Fax | 303-694-9666
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Provider Business Mailing Address
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Address Line | 590 N LOGAN ST
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City | DENVER
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State | CO
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Zip | 80203-3667
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Country | US
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Telephone | 970-624-1103
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Fax | 970-490-4156
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PTL.0018002
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State | MA
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