Basic Information
| Provider Information | |||||||||
| NPI: | 1356743488 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | KELSEY | ||||||||
| MiddleName: | ELISABETH | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13121 E. 17TH AVE., C234 | ||||||||
| Address2: | EDUCATION 2 SOUTH, 5TH FLOOR | ||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037247643 | ||||||||
| FaxNumber: | 3037247664 | ||||||||
| Practice Location | |||||||||
| Address1: | 13121 E. 17TH AVE., C234 | ||||||||
| Address2: | EDUCATION 2 SOUTH, 5TH FLOOR | ||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037247643 | ||||||||
| FaxNumber: | 3037247664 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2014 | ||||||||
| LastUpdateDate: | 09/19/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PTL.0012882 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.