Healthcare Provider Details

I. General information

NPI: 1174127229
Provider Name (Legal Business Name): PHYLLIS ELIZABETH ZILM PT/CLT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2020
Last Update Date: 11/29/2020
Certification Date: 11/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 BLAKE AVE
GLENWOOD SPRINGS CO
81601-4259
US

IV. Provider business mailing address

173 PIEDMONT RD
GLENWOOD SPRINGS CO
81601-9518
US

V. Phone/Fax

Practice location:
  • Phone: 970-384-7105
  • Fax:
Mailing address:
  • Phone: 970-948-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2057
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: