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NPI Code Detail

MEDICARE: KIP ORLO KOEHLER M.S.P.T.

MEDICARE: KIP ORLO KOEHLER M.S.P.T.
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
1225100000XPhysical TherapistPT-1132AR
2225100000XPhysical TherapistPT-009525-LPA

General Provider Information

NPI Number : 1801889852
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIP ORLO KOEHLER M.S.P.T.
Provider Business Mailing Address
First Line : 4102 PINION DR
Second Line :
City : USAF ACADEMY
State : CO
Zip : 80840-2502
Country : US
Telephone Number : 719-333-3107
Fax Number :
Provider Business Practice Location Address
First Line : 4102 PINION DR
Second Line :
City : USAF ACADEMY
State : CO
Zip : 80840-2502
Country : US
Telephone Number : 719-333-3107
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2005
Last Update Date : 05/02/2008

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