MEDICARE: MAKE THE CONNECTION 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	225100000X	Physical Therapist	5608	CO

General Provider Information

NPI Number	:	1679798912
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAKE THE CONNECTION LLC

Provider Business Mailing Address
First Line	:	PO BOX 21150
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80308-4150
Country	:	US
Telephone Number	:	303-546-9158
Fax Number	:	303-546-9107

Provider Business Practice Location Address
First Line	:	5277 MANHATTAN CIR
Second Line	:	STE 103
City	:	BOULDER
State	:	CO
Zip	:	80303-8201
Country	:	US
Telephone Number	:	720-352-7532
Fax Number	:	303-664-1778

Authorized Official
Title or Position	:	OWNER
Name	:	SHARON SWITZER
Credential	:	PT
Telephone Number	:	720-352-7532

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	01/29/2008

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Directions to “MAKE THE CONNECTION LLC ” Practice Location

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