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General NPI Number Information
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NPI Number | 1053352898
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VALLEY REHABILITATION, PC
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3150 N 12TH ST GARDEN LEVEL
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City | GRAND JUNCTION
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State | CO
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Zip | 81506-2863
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Country | US
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Telephone | 970-241-5856
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Fax | 970-241-8599
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Provider Business Mailing Address
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Address Line | PO BOX 10700
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City | GRAND JUNCTION
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State | CO
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Zip | 81502-5517
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Country | US
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Telephone | 970-241-5856
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Fax | 970-241-8599
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Authorized Official
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Title or Position | FINANCIAL MANAGER
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Name | MRS. SHARON A CAVANAH
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Credential |
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Telephone | 970-241-5856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | CO
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