Healthcare Provider Details

I. General information

NPI: 1962943837
Provider Name (Legal Business Name): ROCKY MOUNTAIN THERAPY LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2017
Last Update Date: 02/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

883 JERSEY ST
DENVER CO
80220
US

IV. Provider business mailing address

12528 W 77TH PL
ARVADA CO
80005-2954
US

V. Phone/Fax

Practice location:
  • Phone: 303-378-1604
  • Fax:
Mailing address:
  • Phone: 303-378-1604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA.0013004
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL GRIFFITH
Title or Position: CEO
Credential:
Phone: 303-378-1604