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NPI Code Detail

MEDICARE: LEGACY REHABILITATION, INC.

MEDICARE: LEGACY REHABILITATION, 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
1225100000XPhysical TherapistPTL 0007803CO

General Provider Information

NPI Number : 1821411851
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEGACY REHABILITATION, INC.
Provider Business Mailing Address
First Line : 1475 CHESHAM CIR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-8623
Country : US
Telephone Number : 719-229-2718
Fax Number : 719-593-7084
Provider Business Practice Location Address
First Line : 1475 CHESHAM CIR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-8623
Country : US
Telephone Number : 719-229-2718
Fax Number : 719-593-7084
Authorized Official
Title or Position : CEO
Name : LEA HAY
Credential : P.T.
Telephone Number : 719-229-2718
Provider Enumeration Date : 01/27/2014
Last Update Date : 01/27/2014

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Directions to “LEGACY REHABILITATION, INC. ” Practice Location

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