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General NPI Number Information
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NPI Number | 1922642859
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Entity Type | Organization
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Legal Business Name | REFORM HEALTH & REHAB, LLC
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 2861 W 120TH AVE STE 120
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City | WESTMINSTER
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State | CO
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Zip | 80234-2985
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Country | US
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Telephone | 303-469-6980
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Fax | 303-469-6984
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Provider Business Mailing Address
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Address Line | PO BOX 5718
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City | KALISPELL
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State | MT
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Zip | 59903-5718
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Country | US
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Telephone | 406-756-0134
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Fax | 406-309-2579
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Authorized Official
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Title or Position | CEO, MANAGING MEMBER
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Name | BLAINE STIMAC
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Credential | MSPT
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Telephone | 406-756-1128
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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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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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