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General NPI Number Information
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NPI Number | 1285452649
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Entity Type | Individual
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Provider Name | KATHRYN DICKSON PT
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Gender | Female
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 1000 GRANBY PARK DR S
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City | GRANBY
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State | CO
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Zip | 80446-5304
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Country | US
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Telephone | 970-887-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 2009 LOU ELLEN LN
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City | HOUSTON
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State | TX
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Zip | 77018-6117
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Country | US
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Telephone | 713-302-8044
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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 | 0018696
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License Number State | CO
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