Healthcare Provider Details

I. General information

NPI: 1548436504
Provider Name (Legal Business Name): ADEO COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2780 28TH AVE
GREELEY CO
80634-7803
US

IV. Provider business mailing address

2780 28TH AVE
GREELEY CO
80634-7803
US

V. Phone/Fax

Practice location:
  • Phone: 970-339-2444
  • Fax: 970-339-0068
Mailing address:
  • Phone: 970-339-2444
  • Fax: 970-339-0068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEANNE JOHNSTON
Title or Position: CLINIC DIRECTOR
Credential:
Phone: 970-339-0011