# GUNBARREL PHYSICAL THERAPY AND MASSAGE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295924678
- **Authorized official:** MR. MICHAEL S PERILLO (OWNER)
- **Authorized official phone:** (303) 530-4415

## Contact information

- **Practice address:** 6545 GUNPARK DR, SUITE \#270, BOULDER, CO 80301-3347
- **Practice address phone:** (303) 530-4415
- **Practice address fax:** (303) 530-4413
- **Mailing address:** 6545 GUNPARK DR, SUITE \#270, BOULDER, CO 80301-3347
- **Mailing address phone:** (303) 530-4415
- **Mailing address fax:** (303) 530-4413

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 42528420000 | CO | Yes |

## Other

- **Enumeration date:** 10/22/2007
- **Last updated:** 10/22/2007