Provider Demographics
NPI:1427506807
Name:FLATHERS, KIRK
Entity type:Individual
Prefix:
First Name:KIRK
Middle Name:
Last Name:FLATHERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 TESLA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-3232
Mailing Address - Country:US
Mailing Address - Phone:719-761-3432
Mailing Address - Fax:
Practice Address - Street 1:1226 TESLA DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-3232
Practice Address - Country:US
Practice Address - Phone:719-761-3432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator