Provider Demographics
NPI:1174877724
Name:KATSMAN, ROSTISLAV (MPT)
Entity type:Individual
Prefix:MR
First Name:ROSTISLAV
Middle Name:
Last Name:KATSMAN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9123 E MISSISSIPPI AVE APT 24-303
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-6890
Mailing Address - Country:US
Mailing Address - Phone:818-512-0059
Mailing Address - Fax:
Practice Address - Street 1:9123 E MISSISSIPPI AVE APT 24-303
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-6890
Practice Address - Country:US
Practice Address - Phone:818-512-0059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist