| NPI | 1912243833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUDY JOSEF HABERZETTL CEO/Owner 719-310-1741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 8876) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 7620PT) |
| 225100000X Physical Therapist (Licence: FL 25790) | |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2012-12-20 |