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General NPI Number Information
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NPI Number | 1538780952
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Entity Type | Organization
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Legal Business Name | CONCIERGE PHYSICAL SOLUTIONS LLC
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Dates
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Enumeration Date | 04/27/2020
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Last Update Date | 04/27/2020
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Provider Practice Location Address
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Address Line | 1164 S ACOMA ST
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City | DENVER
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State | CO
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Zip | 80210-1592
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Country | US
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Telephone | 303-416-3296
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Fax |
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Provider Business Mailing Address
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Address Line | 1164 S ACOMA ST UNIT 378C
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City | DENVER
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State | CO
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Zip | 80210-1648
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Country | US
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Telephone | 772-485-4445
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Fax |
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Authorized Official
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Title or Position | OWNER AND PHYSICAL THERAPIST
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Name | DR. NICHOLAS CHARLES SUIVSKI
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Credential | DPT
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Telephone | 772-485-4445
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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