Provider Demographics
NPI:1194124099
Name:CALABRESE, KRISTINA
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 VILLAGE SQUARE DR
Mailing Address - Street 2:#101
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-3692
Mailing Address - Country:US
Mailing Address - Phone:303-805-5156
Mailing Address - Fax:303-805-5157
Practice Address - Street 1:7505 VILLAGE SQUARE DR
Practice Address - Street 2:#101
Practice Address - City:CASTLE PINES
Practice Address - State:CO
Practice Address - Zip Code:80108-3692
Practice Address - Country:US
Practice Address - Phone:303-805-5156
Practice Address - Fax:303-805-5157
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL0012411225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist