MEDICARE: FRONT RANGE THERAPY SYSTEMS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number	:	1073535118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRONT RANGE THERAPY SYSTEMS, INC.

Provider Business Mailing Address
First Line	:	802 W DRAKE RD
Second Line	:	SUITE 145
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-5567
Country	:	US
Telephone Number	:	970-492-6238
Fax Number	:	970-492-6206

Provider Business Practice Location Address
First Line	:	802 W DRAKE RD
Second Line	:	SUITE 133
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-5567
Country	:	US
Telephone Number	:	970-492-6238
Fax Number	:	970-492-6206

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JOHN ROBERT WILSON
Credential	:
Telephone Number	:	970-482-0198

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	05/24/2010

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