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General NPI Number Information
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NPI Number | 1174999577
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Entity Type | Organization
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Legal Business Name | ELK MOUNTAIN THERAPY ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 322 N MAIN ST
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City | GUNNISON
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State | CO
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Zip | 81230-2404
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Country | US
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Telephone | 970-641-2001
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Fax | 970-641-4596
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Provider Business Mailing Address
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Address Line | 322 N MAIN ST
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City | GUNNISON
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State | CO
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Zip | 81230-2404
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Country | US
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Telephone | 970-641-2001
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Fax | 970-641-4596
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | CYNTHIA C GRIGGS
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Credential | OTR/CHT
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Telephone | 970-641-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | CO
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