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General NPI Number Information
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NPI Number | 1265980569
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Entity Type | Organization
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Legal Business Name | ORTHOMOTION INC.
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 1240 PINE ST SUITE 113
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City | BOULDER
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State | CO
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Zip | 80302-4809
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Country | US
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Telephone | 305-505-5596
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Fax |
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Provider Business Mailing Address
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Address Line | 1240 PINE ST SUITE 113
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City | BOULDER
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State | CO
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Zip | 80302-4809
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | LORENA BUTRON
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Credential | OTRL
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Telephone | 305-505-5596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | OT0003373
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License Number State | CO
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