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General NPI Number Information
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NPI Number | 1235599424
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Entity Type | Individual
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Provider Name | KELLY FRATESI
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Gender | Female
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Dates
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Enumeration Date | 03/01/2016
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Last Update Date | 03/01/2016
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Provider Practice Location Address
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Address Line | 1622 W 33RD AVE
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City | DENVER
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State | CO
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Zip | 80211-3507
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Country | US
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Telephone | 662-820-5355
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Fax |
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Provider Business Mailing Address
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Address Line | 1622 W 33RD AVE
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City | DENVER
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State | CO
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Zip | 80211-3507
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Country | US
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Telephone |
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL.0013800
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License Number State | CO
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