MEDICARE: KIMBERLY MICHELLE SAUNDERS DPT

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	7031	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1679653984	OTHER		NPI

General Provider Information

NPI Number	:	1679653984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY MICHELLE SAUNDERS DPT

Provider Business Mailing Address
First Line	:	3938 JFK PKWY
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3086
Country	:	US
Telephone Number	:	970-207-1500
Fax Number	:	970-207-0075

Provider Business Practice Location Address
First Line	:	3938 JFK PKWY
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3086
Country	:	US
Telephone Number	:	970-207-1500
Fax Number	:	970-207-0075

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	09/26/2016

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