Provider Demographics
NPI:1447640073
Name:O'HALLORAN, ABBY
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:O'HALLORAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:KOSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4367 S EAGLE CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1302
Mailing Address - Country:US
Mailing Address - Phone:308-380-5992
Mailing Address - Fax:
Practice Address - Street 1:14800 E BELLEVIEW DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-2258
Practice Address - Country:US
Practice Address - Phone:303-680-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTA.0013075225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant