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General NPI Number Information
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NPI Number | 1245212711
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Entity Type | Organization
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Legal Business Name | PUEBLO REHAB & ORTHOPEDIC THERAPY LLC
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 03/18/2016
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Provider Practice Location Address
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Address Line | 3525 SPAULDING AVE
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City | PUEBLO
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State | CO
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Zip | 81008-2208
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Country | US
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Telephone | 719-542-4444
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Fax | 719-543-1990
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Provider Business Mailing Address
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Address Line | 3525 SPAULDING AVENUE
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City | PUEBLO
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State | CO
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Zip | 81008
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Country | US
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Telephone | 719-542-4444
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Fax | 719-543-1990
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS LYNDSEY BROOKE LANGDON
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Credential |
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Telephone | 719-542-4444
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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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