| NPI | 1477855179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT WACKER Owner 970-217-8018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CO 8600) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2011-07-07 |