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General NPI Number Information
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NPI Number | 1699154419
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Entity Type | Organization
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Legal Business Name | KINNEY PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 05/26/2015
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Last Update Date | 11/14/2018
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Provider Practice Location Address
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Address Line | 1221 S CLARKSON ST SUITE 311
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City | DENVER
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State | CO
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Zip | 80210-1625
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Country | US
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Telephone | 720-432-0155
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 S CLARKSON ST STE 311
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City | DENVER
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State | CO
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Zip | 80210-1628
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Country | US
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Telephone | 720-432-0155
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Fax | 720-634-0802
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | CHARLES PATRICK KINNEY
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Credential | PT, DPT
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Telephone | 720-432-0155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 0012212
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License Number State | CO
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