Healthcare Provider Details

I. General information

NPI: 1093329237
Provider Name (Legal Business Name): TWO RIVERS PHYSICAL THERAPY AND WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2020
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 NORTH AVE
GRAND JUNCTION CO
81501-7531
US

IV. Provider business mailing address

609 NORTH AVE
GRAND JUNCTION CO
81501-7531
US

V. Phone/Fax

Practice location:
  • Phone: 970-260-8326
  • Fax:
Mailing address:
  • Phone: 970-260-8326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE CARR
Title or Position: PRESIDENT
Credential:
Phone: 970-260-8326