| NPI | 1477150597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE LEE MICKLICH Physical Therapist 719-580-4076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-01 |