=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932272689
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REHABILITATION ASSOCIATES OF COLORADO PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2006
-----------------------------------------------------
Last Update Date | 01/14/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8515 PEARL ST STE 350
-----------------------------------------------------
City | THORNTON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80229-4832
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-853-8671
-----------------------------------------------------
Fax | 303-322-9142
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8515 PEARL ST STE 350
-----------------------------------------------------
City | THORNTON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80229-4832
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-316-0900
-----------------------------------------------------
Fax | 303-322-9142
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CONTROLLER
-----------------------------------------------------
Name | SONI FOX
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 303-853-8671
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------