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General NPI Number Information
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NPI Number | 1144639873
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Entity Type | Organization
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Legal Business Name | BREAK THROUGH THERAPY PLLC
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Dates
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Enumeration Date | 08/06/2014
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Last Update Date | 08/06/2014
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Provider Practice Location Address
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Address Line | 1349 PIKE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80904-1230
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Country | US
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Telephone | 757-846-6988
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Fax |
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Provider Business Mailing Address
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Address Line | 1349 PIKE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80904-1230
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Country | US
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Telephone | 757-846-6988
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | AMANDA KUTE
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Credential | OTD, OTR, BCP, HPCS
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Telephone | 757-846-6988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2588
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License Number State | CO
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