Provider Demographics
NPI:1366787178
Name:KLATASKE, COURTNEY KISER (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:KISER
Last Name:KLATASKE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5387 LIGHTHOUSE POINT CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-7917
Mailing Address - Country:US
Mailing Address - Phone:970-372-7434
Mailing Address - Fax:
Practice Address - Street 1:5387 LIGHTHOUSE POINT CT
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-7917
Practice Address - Country:US
Practice Address - Phone:970-372-7434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00119552081N0008X
AZ97562081N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular Medicine