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General NPI Number Information
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NPI Number | 1700470168
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Entity Type | Organization
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Legal Business Name | NEURO LOGIC REHABILITATION AND WELLNESS
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Dates
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Enumeration Date | 02/25/2021
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Last Update Date | 04/02/2024
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Provider Practice Location Address
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Address Line | 114 SUNBIRD CLIFFS LN
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-8013
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Country | US
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Telephone | 847-502-5971
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Fax | 719-691-7994
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Provider Business Mailing Address
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Address Line | 114 SUNBIRD CLIFFS LN
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-8013
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Country | US
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Telephone | 847-502-5971
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Fax | 719-691-7994
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Authorized Official
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Title or Position | OWNER
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Name | RYAN MUELLER
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Credential |
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Telephone | 847-502-5971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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