Healthcare Provider Details
I. General information
NPI: 1982475463
Provider Name (Legal Business Name): INSPIRATION FIELD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/12/2024
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27580 W. US HWY 50
LA JUNTA CO
81050
US
IV. Provider business mailing address
612 ADAMS AVE
LA JUNTA CO
81050-2535
US
V. Phone/Fax
- Phone: 719-384-8700
- Fax:
- Phone: 719-384-8741
- Fax: 719-384-4278
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
CAMERON
SALZBRENNER
Title or Position: CFO
Credential:
Phone: 719-469-6133