Provider Demographics
NPI:1699154419
Name:KINNEY PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:KINNEY PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:720-432-0155
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
Practice Address - Street 2:SUITE 311
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-1625
Practice Address - Country:US
Practice Address - Phone:720-432-0155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00122122251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty