Healthcare Provider Details
I. General information
NPI: 1326631318
Provider Name (Legal Business Name): CP AND IP THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/19/2021
Last Update Date: 02/19/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
141 LOWER BULLWINKLE
ASPEN CO
81612
US
IV. Provider business mailing address
PO BOX 295
WOODY CREEK CO
81656-0295
US
V. Phone/Fax
- Phone: 970-618-6347
- Fax:
- Phone: 970-618-6347
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
ROBIN
SEVERY
PFAUTZ
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT, MS
Phone: 970-618-6347