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General NPI Number Information
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NPI Number | 1962999581
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Entity Type | Organization
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Legal Business Name | KINETIC FOOT AND ANKLE CLINIC, LLC
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 5420 S QUEBEC ST STE 106
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-1902
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Country | US
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Telephone | 720-295-4864
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Fax | 855-805-9391
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Provider Business Mailing Address
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Address Line | 5420 S QUEBEC ST STE 106
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-1902
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Country | US
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Telephone | 720-295-4864
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Fax | 855-805-9391
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Authorized Official
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Title or Position | OWNER
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Name | MARC HOUSE
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Credential | DPM
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Telephone | 720-295-4864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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