| NPI | 1174864359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS PETERSON Co Owner 719-480-3438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2013-10-21 |