Provider Demographics
NPI:1861609661
Name:AZBELL, KRISTINA L (MHS, PT, PCS)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:L
Last Name:AZBELL
Suffix:
Gender:F
Credentials:MHS, PT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7703 S JACKSON CIR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-3518
Mailing Address - Country:US
Mailing Address - Phone:303-995-3403
Mailing Address - Fax:303-740-7020
Practice Address - Street 1:7703 S JACKSON CIR
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-3518
Practice Address - Country:US
Practice Address - Phone:303-995-3403
Practice Address - Fax:303-740-7020
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38962251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics