Individual
MARK KINCAID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 419-7139
(970) 493-1794
Mailing address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 419-7139
(970) 493-1794
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0016848
CO
225100000X
Physical Therapist
Primary
PTL.0016848
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTL.0016848
PHYSICAL THERAPY LICENSE
CO
Enumeration date
03/04/2020
Last updated
11/17/2020
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