Healthcare Provider Details

I. General information

NPI: 1932833191
Provider Name (Legal Business Name): ROC OTX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 11/17/2024
Certification Date: 11/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 INVERNESS DR E
ENGLEWOOD CO
80112-5301
US

IV. Provider business mailing address

7848 S VALLEYHEAD WAY
AURORA CO
80016-7452
US

V. Phone/Fax

Practice location:
  • Phone: 952-250-2414
  • Fax:
Mailing address:
  • Phone: 952-250-2414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: AMY ROCHFORD
Title or Position: OWNER
Credential: OTD, OTR/L
Phone: 952-250-2414