Katherine Breanne Patrick, DPT

Individual provider Active NPI Orthopedic Physical Therapist · Berthoud, CO

NPI 1962836007 · NPPES record last updated Feb 20, 2017

Key facts

NPI
1962836007
Entity type
Individual (NPI type 1)
Primary specialty
Orthopedic Physical Therapist 2251X0800X
License
PTL.0012586 (CO)
Practice address
111 E Indiana Ave
Berthoud, CO 80513-2643
Phone
(720) 849-5856
NPI assigned
Aug 26, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT 38198CAMDPhysical Therapist
PTL.0012586COMDOrthopedic Physical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 38198 CA
Orthopedic Physical Therapist 2251X0800X PTL.0012586 CO Yes

Addresses

Primary practice location

111 E Indiana Ave
Berthoud, CO 80513-2643

Mailing address

111 E Indiana Ave
Berthoud, CO 80513-2643
Phone (720) 849-5856

Other providers in Berthoud, CO

All providers in Berthoud, CO · Orthopedic Physical Therapist in Colorado

Sources for this page

Verify at the official NPI Registry.