| NPI | 1104168228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA OWSLEY Office Manager 719-266-6022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: CO 2451) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2017-04-19 |