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General NPI Number Information
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NPI Number | 1245749704
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Entity Type | Individual
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Provider Name | KEVIN RAYMONDE BERNING
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Gender | Male
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Dates
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Enumeration Date | 09/27/2017
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 175 INVERNESS DR W
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City | ENGLEWOOD
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State | CO
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Zip | 80112-5065
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Country | US
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Telephone | 303-601-4099
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Fax |
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Provider Business Mailing Address
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Address Line | 1989 BLUE SAGE LN
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City | CASTLE ROCK
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State | CO
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Zip | 80104-7888
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Country | US
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Telephone | 303-601-4099
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT7045
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License Number State | TX
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