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General NPI Number Information
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NPI Number | 1902649627
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Entity Type | Individual
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Provider Name | KYLE DOW
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Gender | Male
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Dates
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Enumeration Date | 06/18/2024
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 1599 INGALLS ST
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City | LAKEWOOD
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State | CO
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Zip | 80214-1505
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Country | US
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Telephone | 303-232-3551
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Fax |
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Provider Business Mailing Address
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Address Line | 3715 OWENS ST APT 4
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City | WHEAT RIDGE
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State | CO
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Zip | 80033-5506
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Country | US
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Telephone | 804-239-3271
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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 | PTA.0014987
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PTA.0014987
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License Number State | CO
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