Individual
KELLY WAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
601 E 18TH AVE STE 130, DENVER, CO 80203-1493
(303) 315-1951
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL.0007927
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94181829
—
CO
Enumeration date
09/30/2006
Last updated
10/18/2018
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