| NPI | 1114420114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER BOEHLKE Owner 719-313-9466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: CO 0012668) |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2023-10-30 |