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General NPI Number Information
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NPI Number | 1457662488
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Entity Type | Individual
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Provider Name | KATIE ANN CARLSON R.P.T.A. , LMT
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Gender | Female
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 06/15/2020
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Provider Practice Location Address
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Address Line | 6881 S HOLLY CIR STE 207
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City | CENTENNIAL
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State | CO
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Zip | 80112-1145
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Country | US
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Telephone | 303-221-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 11886 BARRETT ST
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City | PARKER
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State | CO
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Zip | 80138-8011
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Country | US
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Telephone | 620-212-3533
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 14-02081
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State | CO
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