Healthcare Provider Details

I. General information

NPI: 1235811936
Provider Name (Legal Business Name): SOPRIS REHABILITATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 E VALLEY RD UNIT 202A
BASALT CO
81621-8370
US

IV. Provider business mailing address

1383 BARBER DR
CARBONDALE CO
81623-1886
US

V. Phone/Fax

Practice location:
  • Phone: 970-274-8461
  • Fax: 970-927-9238
Mailing address:
  • Phone: 970-274-8461
  • Fax: 970-927-9238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
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: MR. DANIEL W RITSCHARD
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, MSPT
Phone: 970-274-8461