Healthcare Provider Details
I. General information
NPI: 1114212966
Provider Name (Legal Business Name): THERAPY FOR INDEPENDENCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2011
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7390 W EASTMAN PL
LAKEWOOD CO
80227-5039
US
IV. Provider business mailing address
7390 W EASTMAN PL
LAKEWOOD CO
80227-5039
US
V. Phone/Fax
- Phone: 303-988-2848
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251G0304X |
| Taxonomy | Geriatric Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KIM
PHELPS
Title or Position: OWNER
Credential: PT
Phone: 303-790-1910