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General NPI Number Information
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NPI Number | 1912243833
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Entity Type | Organization
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Legal Business Name | PROACTIVE SOLUTIONS,INC.
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Dates
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Enumeration Date | 12/20/2012
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 1441 FIELDWOOD CT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-5635
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Country | US
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Telephone | 719-310-1741
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Fax | 719-533-8188
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Provider Business Mailing Address
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Address Line | 1441 FIELDWOOD CT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-5635
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Country | US
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Telephone | 719-310-1741
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Fax | 719-533-8188
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MR. RUDY JOSEF HABERZETTL
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Credential | MSPT, CEES
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Telephone | 719-310-1741
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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 | 7620PT
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License Number State | AZ
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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 | 25790
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 8876
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License Number State | CO
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