# KID PHYSICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053921502
- **Authorized official:** KRISTY MILLER (PRESIDENT)
- **Authorized official phone:** (860) 593-6868

## Contact information

- **Practice address:** 18885 E EASTER PL, CENTENNIAL, CO 80016-2136
- **Practice address phone:** (860) 593-6868
- **Mailing address:** 16350 E ARAPAHOE RD STE 146, AURORA, CO 80016-1557
- **Mailing address phone:** (860) 593-6868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/08/2020
- **Last updated:** 12/23/2020