Provider Demographics
NPI:1194230938
Name:MCINTOSH, KAYLEE DIANA (DPT)
Entity type:Individual
Prefix:DR
First Name:KAYLEE
Middle Name:DIANA
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:KAYLEE
Other - Middle Name:DIANA
Other - Last Name:DEMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1855 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2325
Mailing Address - Country:US
Mailing Address - Phone:303-928-3849
Mailing Address - Fax:
Practice Address - Street 1:1855 PLAZA DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2325
Practice Address - Country:US
Practice Address - Phone:303-928-3849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-01
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16243208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty