Provider Demographics
NPI:1912645946
Name:MOHICA, KIANI CHRISTABEL (PT, DPT)
Entity type:Individual
Prefix:
First Name:KIANI
Middle Name:CHRISTABEL
Last Name:MOHICA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3102 S PARKER RD STE A15
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3108
Mailing Address - Country:US
Mailing Address - Phone:303-338-8598
Mailing Address - Fax:
Practice Address - Street 1:3102 S PARKER RD STE A15
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3108
Practice Address - Country:US
Practice Address - Phone:303-338-8598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-20
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305215018208100000X
COCP014305T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305215018OtherSTATE LICENSE