Provider Demographics
NPI:1124453535
Name:KINNEY, CHARLES PATRICK (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:PATRICK
Last Name:KINNEY
Suffix:
Gender:M
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 1:1221 S CLARKSON ST STE 311
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-1628
Mailing Address - Country:US
Mailing Address - Phone:720-432-0155
Mailing Address - Fax:720-634-0802
Practice Address - Street 1:1221 S CLARKSON ST STE 311
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-1628
Practice Address - Country:US
Practice Address - Phone:720-432-0155
Practice Address - Fax:720-634-0802
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0012212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist