Basic Information
Provider Information
NPI: 1811377880
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SPRENGER
FirstName: KATHY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: L.M.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12930 W 6TH PL
Address2:  
City: LAKEWOOD
State: CO
PostalCode: 804014624
CountryCode: US
TelephoneNumber: 7202756655
FaxNumber:  
Practice Location
Address1: 8725 WADSWORTH BLVD STE A
Address2:  
City: ARVADA
State: CO
PostalCode: 800030922
CountryCode: US
TelephoneNumber: 3034257298
FaxNumber: 3039408330
Other Information
ProviderEnumerationDate: 06/04/2015
LastUpdateDate: 06/04/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225700000XMT.0015624COY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist 

No ID Information.


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