Provider Demographics
NPI:1255580023
Name:KOLATH, ALEXIS GAINES (PT)
Entity type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:GAINES
Last Name:KOLATH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14900 E CENTER AVE
Mailing Address - Street 2:UNIT H
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3834
Mailing Address - Country:US
Mailing Address - Phone:720-272-7702
Mailing Address - Fax:
Practice Address - Street 1:14900 E CENTER AVE
Practice Address - Street 2:UNIT H
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3834
Practice Address - Country:US
Practice Address - Phone:720-272-7702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8189225100000X
CO8920225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist