Healthcare Provider Details

I. General information

NPI: 1982392817
Provider Name (Legal Business Name): CASTLE ROCK THERAPIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12919 STROH RANCH CT UNIT F
PARKER CO
80134-7709
US

IV. Provider business mailing address

2 OAKWOOD PARK PLZ STE 200
CASTLE ROCK CO
80104-1885
US

V. Phone/Fax

Practice location:
  • Phone: 720-788-7365
  • Fax: 720-294-1426
Mailing address:
  • Phone: 720-788-7365
  • Fax: 720-294-0284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR MARK PFEIFER
Title or Position: OWNER
Credential: DPT
Phone: 720-788-7365