| NPI | 1861916827 |
|---|---|
| Former Legal Business Name | FARM TO TREATMENT TABLE, LLC |
| Entity Type | Organization |
| Authorized Contact | BECKY KELLOGG Owner/President 303-931-6478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2022-07-21 |