MEDICARE: FUNCTIONAL COMPASS LLC

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	251E00000X	Home Health Agency	6868	CO

General Provider Information

NPI Number	:	1457867061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FUNCTIONAL COMPASS LLC

Provider Business Mailing Address
First Line	:	PO BOX 1012
Second Line	:
City	:	CARBONDALE
State	:	CO
Zip	:	81623-1012
Country	:	US
Telephone Number	:	720-218-2731
Fax Number	:

Provider Business Practice Location Address
First Line	:	868 MELISSA LN
Second Line	:
City	:	CARBONDALE
State	:	CO
Zip	:	81623-2819
Country	:	US
Telephone Number	:	720-218-2731
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	MR. CHAD SEAHORN
Credential	:	MSPT
Telephone Number	:	720-218-2731

Provider Enumeration Date	:	12/19/2017
Last Update Date	:	12/19/2017

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Directions to “FUNCTIONAL COMPASS LLC ” Practice Location

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