Healthcare Provider Details

I. General information

NPI: 1134784291
Provider Name (Legal Business Name): FLOWSTATE PHYSICAL THERAPY & PERFORMANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2019
Last Update Date: 09/29/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2749 IRIS AVE
BOULDER CO
80304-2433
US

IV. Provider business mailing address

2749 IRIS AVE
BOULDER CO
80304-2433
US

V. Phone/Fax

Practice location:
  • Phone: 720-606-0070
  • Fax: 720-580-9799
Mailing address:
  • Phone: 720-606-0070
  • Fax: 720-580-9799

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: ALLYSON FRIDAY
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: DPT
Phone: 720-606-0070