=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871320176
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KALIBRATE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2024
-----------------------------------------------------
Last Update Date | 09/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4150 OSAGE ST
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80211-2543
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-522-0796
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4150 OSAGE ST
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80211-2543
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-522-0796
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER, PHYSICAL THERAPIST
-----------------------------------------------------
Name | ALEXANDRA KALLNER
-----------------------------------------------------
Credential | PT, DPT
-----------------------------------------------------
Telephone | 480-522-0796
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------