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General NPI Number Information
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NPI Number | 1437271814
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Entity Type | Organization
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Legal Business Name | SUNLIGHT PHYSICAL THERAPY SERVICES
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 08/22/2007
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Provider Practice Location Address
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Address Line | 2600 S OAK HURST CT APT 4 #4
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-4459
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Country | US
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Telephone | 970-309-1992
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2826
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81602-2826
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Country | US
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Telephone | 970-309-1992
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. JUSTYNA LUKASZCZYK
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Credential | PT
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Telephone | 970-309-1992
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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 | 7461
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License Number State | CO
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