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Organization
MMP INC
Active
Organization
MMP INC
Active
Other names
Headwaters Home Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIKELLE MARIE PETERSON PT (PRESIDENT)
(303) 862-1840
Entity
Organization
Contact information
Practice address
29670 COUNTY ROAD 372A, BUENA VISTA, CO 81211-9704
(303) 862-1840
Mailing address
29670 COUNTY ROAD 372A, BUENA VISTA, CO 81211-9704
(303) 862-1840
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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