Healthcare Provider Details

I. General information

NPI: 1790310902
Provider Name (Legal Business Name): SISU THERAPIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 07/27/2025
Certification Date: 07/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1296 MAIN ST UNIT B
WINDSOR CO
80550-7903
US

IV. Provider business mailing address

1296 MAIN ST UNIT B
WINDSOR CO
80550-7903
US

V. Phone/Fax

Practice location:
  • Phone: 970-561-7111
  • Fax: 970-561-7112
Mailing address:
  • Phone: 970-561-7111
  • Fax: 970-561-7112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical 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: LAURA A SIMENSON
Title or Position: OWNER
Credential: PT, DPT
Phone: 970-561-7111