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General NPI Number Information
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NPI Number | 1417016536
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR TOTAL REHABILITATION
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 02/06/2018
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Provider Practice Location Address
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Address Line | 21 MONTEBELLO RD
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City | PUEBLO
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State | CO
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Zip | 81001-1236
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Country | US
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Telephone | 719-546-0037
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Fax | 719-546-0039
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Provider Business Mailing Address
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Address Line | 21 MONTEBELLO RD
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City | PUEBLO
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State | CO
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Zip | 81001-1236
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Country | US
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Telephone | 719-546-0037
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Fax | 719-546-0039
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Authorized Official
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Title or Position | OWNER
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Name | MR. BARRY D BROWN
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Credential | PT
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Telephone | 719-546-0037
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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 | 2749
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4230
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License Number State | CO
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