MEDICARE: RT2G

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	2278G1100X	General Care Certified Respiratory Therapist	1388	CO

General Provider Information

NPI Number	:	1811209430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RT2G

Provider Business Mailing Address
First Line	:	749 OXFORD LN
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2243
Country	:	US
Telephone Number	:	970-775-0382
Fax Number	:

Provider Business Practice Location Address
First Line	:	749 OXFORD LN
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2243
Country	:	US
Telephone Number	:	970-775-0382
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANGELA MICHELLE SHOCKLEY
Credential	:	CRTT
Telephone Number	:	970-775-0382

Provider Enumeration Date	:	07/12/2010
Last Update Date	:	07/12/2010

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