| NPI | 1487243044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY GENHARDT Cco 970-221-1201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2021-04-21 |