Healthcare Provider Details

I. General information

NPI: 1528762218
Provider Name (Legal Business Name): APRIL D CHRISTOPHERSON OTR L LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 MAIN ST
DELTA CO
81416-1816
US

IV. Provider business mailing address

457 MAIN ST
DELTA CO
81416-1816
US

V. Phone/Fax

Practice location:
  • Phone: 970-975-1362
  • Fax: 970-639-4480
Mailing address:
  • Phone: 970-975-1362
  • Fax: 970-639-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: ABDULLAH IMITAZ
Title or Position: ADMINISTRATIVE BILER
Credential:
Phone: 347-983-0049