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General NPI Number Information
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NPI Number | 1376931683
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Entity Type | Organization
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Legal Business Name | SYNERGY SPORTS AND REHAB LLC
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Dates
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Enumeration Date | 01/08/2015
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Last Update Date | 02/26/2015
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Provider Practice Location Address
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Address Line | 12311 PINE BLUFFS WAY UNIT J
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City | PARKER
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State | CO
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Zip | 80134-4339
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Country | US
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Telephone | 720-313-1585
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Fax |
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Provider Business Mailing Address
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Address Line | 12311 PINE BLUFFS WAY UNIT J
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City | PARKER
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State | CO
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Zip | 80134-4339
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Country | US
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Telephone | 720-313-1585
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | JEFFREY H KATZOFF
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Credential | DPT
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Telephone | 720-313-1585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 9159
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License Number State | CO
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