Healthcare Provider Details

I. General information

NPI: 1174126593
Provider Name (Legal Business Name): FRONT RANGE THERAPISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23830 COUNTY ROAD 48
LA SALLE CO
80645-8612
US

IV. Provider business mailing address

23830 COUNTY ROAD 48
LA SALLE CO
80645-8612
US

V. Phone/Fax

Practice location:
  • Phone: 970-381-3183
  • Fax:
Mailing address:
  • Phone: 970-381-3183
  • 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 Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JACQUELINE LACY HOYER-HELMS
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 970-381-3183