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NPI Code Detail

MEDICARE: KATHERINE REILLY

MEDICARE: KATHERINE REILLY
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
1225200000XPhysical Therapy AssistantPTA.0014505CO
2225200000XPhysical Therapy Assistant2151155TX

General Provider Information

NPI Number : 1346710373
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE REILLY
Provider Business Mailing Address
First Line : 11169 E I25 FRONTAGE RD STE C
Second Line :
City : FIRESTONE
State : CO
Zip : 80504-5211
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11169 E I25 FRONTAGE RD STE C
Second Line :
City : FIRESTONE
State : CO
Zip : 80504-5211
Country : US
Telephone Number : 720-600-0370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2018
Last Update Date : 07/03/2020

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