Provider Demographics
NPI:1962437699
Name:MCMICHAEL, KATHLEEN KOHT (RPT)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:KOHT
Last Name:MCMICHAEL
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1944 JASMINE STREET
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-1541
Mailing Address - Country:US
Mailing Address - Phone:303-399-8020
Mailing Address - Fax:303-393-5164
Practice Address - Street 1:1055 CLERMONT STREET
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220
Practice Address - Country:US
Practice Address - Phone:303-399-8020
Practice Address - Fax:303-393-5164
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist