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General NPI Number Information
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NPI Number | 1114998788
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Entity Type | Organization
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Legal Business Name | COLORADO PHYSICAL THERAPY INSTITUTE, P.C.
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 300 NICKEL ST STE 6
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City | BROOMFIELD
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State | CO
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Zip | 80020-2097
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Country | US
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Telephone | 303-460-9129
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Fax | 303-469-2324
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Provider Business Mailing Address
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Address Line | 300 NICKEL ST STE 6
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City | BROOMFIELD
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State | CO
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Zip | 80020-2097
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Country | US
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Telephone | 303-460-9129
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Fax | 303-469-2324
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | ROGER CARL RETTIG
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Credential | MSPT
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Telephone | 303-460-9129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 2539
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License Number State | CO
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