| NPI | 1700172400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA RENEE PRUTCH Physical Therapist Assistant 719-214-0922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MO 2008015492) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2011-06-22 |