Provider Demographics
NPI:1316615099
Name:BROWN, KATHERINE (DPT, PT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:DPT, PT
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 5584
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443-5584
Mailing Address - Country:US
Mailing Address - Phone:970-790-9600
Mailing Address - Fax:970-790-9610
Practice Address - Street 1:1140 EDWARDS VILLAGE BLVD STE B-105
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632-5525
Practice Address - Country:US
Practice Address - Phone:970-569-3240
Practice Address - Fax:970-569-3260
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL0017893225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist