Provider Demographics
NPI:1992500508
Name:KEENAHAN, KELLY (DPT)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:KEENAHAN
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2072 S CORONA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-4123
Mailing Address - Country:US
Mailing Address - Phone:585-301-7008
Mailing Address - Fax:
Practice Address - Street 1:22 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2908
Practice Address - Country:US
Practice Address - Phone:303-399-1146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.00160542251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics