Provider Demographics
NPI:1104168335
Name:CONLIN, DAVID THOMAS (DPT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:THOMAS
Last Name:CONLIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 801172
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1172
Mailing Address - Country:US
Mailing Address - Phone:800-953-0104
Mailing Address - Fax:
Practice Address - Street 1:41 STATE HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-5008
Practice Address - Country:US
Practice Address - Phone:719-686-0553
Practice Address - Fax:719-687-5374
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL9247225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist