Provider Demographics
NPI:1902436645
Name:GARNER, KIRSTEN (PTA)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:GARNER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9828 MEADE CIR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-2648
Mailing Address - Country:US
Mailing Address - Phone:713-732-8357
Mailing Address - Fax:
Practice Address - Street 1:11169 E I25 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:FIRESTONE
Practice Address - State:CO
Practice Address - Zip Code:80504-5276
Practice Address - Country:US
Practice Address - Phone:720-600-0370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTA.0014746225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant