Healthcare Provider Details

I. General information

NPI: 1124599956
Provider Name (Legal Business Name): CERTIFIED HAND THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 12/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 30TH ST STE 206
BOULDER CO
80301-1026
US

IV. Provider business mailing address

121 S TEJON ST STE 900
COLORADO SPRINGS CO
80903-2207
US

V. Phone/Fax

Practice location:
  • Phone: 720-845-0001
  • Fax: 720-204-1748
Mailing address:
  • Phone: 720-829-2564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. MITIZI HARRISON
Title or Position: DOCTOR OF PHYSICAL THERAOY
Credential: BSPT
Phone: 720-829-2564