MEDICARE: KRISTIN SCHWARZKOPF PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	0011910	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0011910	OTHER	CO	MEDICARE

General Provider Information

NPI Number	:	1063765949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN SCHWARZKOPF PT

Provider Business Mailing Address
First Line	:	3241 W AVONDALE DR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-2207
Country	:	US
Telephone Number	:	515-720-4126
Fax Number	:

Provider Business Practice Location Address
First Line	:	3241 W AVONDALE DR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-2207
Country	:	US
Telephone Number	:	515-720-4126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2012
Last Update Date	:	10/18/2012

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