Healthcare Provider Details
I. General information
NPI: 1114296068
Provider Name (Legal Business Name): NEUROMUSCULAR STRATEGIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/22/2011
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5353 MANHATTAN CIR STE 102
BOULDER CO
80303-4200
US
IV. Provider business mailing address
115 MONARCH CT
LOUISVILLE CO
80027-1242
US
V. Phone/Fax
- Phone: 720-352-0678
- Fax: 720-441-0485
- Phone: 720-352-0678
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | 5050 |
| License Number State | CO |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | COAAA3546 |
| Identifier Type | OTHER |
| Identifier State | CO |
| Identifier Issuer | PTAN # |
VIII. Authorized Official
Name: MR.
MICHAEL
J
KOHM
Title or Position: OWNER
Credential: PT
Phone: 720-352-0678