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Individual

KRISTIE M BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
3434 47TH ST, STE 107, BOULDER, CO 80301-1880
(303) 440-7078
(303) 440-7242
Mailing address
3434 47TH ST, STE 107, BOULDER, CO 80301-1880
(303) 440-7078
(303) 440-7242

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1373
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C500548
PTAN
CO
Enumeration date
04/20/2006
Last updated
12/11/2008
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