Provider Demographics
NPI:1104684737
Name:HORNBURG, KELSEY FITZGERALD (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:FITZGERALD
Last Name:HORNBURG
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10115 S PEORIA ST UNIT 12-205
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-8643
Mailing Address - Country:US
Mailing Address - Phone:970-456-2787
Mailing Address - Fax:
Practice Address - Street 1:9116 W BOWLES AVE STE 10
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-3477
Practice Address - Country:US
Practice Address - Phone:303-978-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0019562225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist