Healthcare Provider Details

I. General information

NPI: 1982919213
Provider Name (Legal Business Name): COMPASS IN-HOME PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 02/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2785 DAFINA DR
LOVELAND CO
80537-2049
US

IV. Provider business mailing address

2785 DAFINA DR
LOVELAND CO
80537-2049
US

V. Phone/Fax

Practice location:
  • Phone: 970-691-0538
  • Fax:
Mailing address:
  • Phone: 970-691-0538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number6467
License Number StateCO

VIII. Authorized Official

Name: ROBERT WARREN BUSSE
Title or Position: PHYSICAL THERAPIST/OWNER
Credential: DPT
Phone: 970-691-0538