Provider Demographics
NPI:1487115762
Name:KELLER, CARYN FERRIGNO (PT, DPT, NCS)
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:FERRIGNO
Last Name:KELLER
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:CARYN
Other - Middle Name:NICOLE
Other - Last Name:FERRIGNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 BROADMOOR AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3641
Mailing Address - Country:US
Mailing Address - Phone:908-566-5072
Mailing Address - Fax:
Practice Address - Street 1:525 E FOUNTAIN BLVD STE 150
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-4465
Practice Address - Country:US
Practice Address - Phone:719-286-0780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015727225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist