Provider Demographics
NPI:1063888931
Name:PALAZZOLO, KATELYN (DPT, PT)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:PALAZZOLO
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N WASHINGTON ST
Mailing Address - Street 2:APT #203
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3375
Mailing Address - Country:US
Mailing Address - Phone:314-565-1609
Mailing Address - Fax:
Practice Address - Street 1:10355 E ILIFF AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80247-3622
Practice Address - Country:US
Practice Address - Phone:303-755-4955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013529225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist