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General NPI Number Information
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NPI Number | 1447436282
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Entity Type | Individual
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Provider Name | KELLEEN ANN SHANAHAN P.T.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 4952 E DAVIES DR
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City | CENTENNIAL
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State | CO
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Zip | 80122-2330
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Country | US
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Telephone | 720-877-3960
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Fax | 303-751-6169
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Provider Business Mailing Address
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Address Line | 4952 E DAVIES DR
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City | CENTENNIAL
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State | CO
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Zip | 80122-2330
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Country | US
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Telephone | 720-877-3960
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Fax | 303-751-6169
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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.0003364
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License Number State | CO
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