# COLORADO OCCUPATIONAL AND LYMPHEDEMA THERAPY LLC

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

## Provider details

- **NPI number:** 1922540558
- **Authorized official:** MR. MICHAEL J E FYFFE (OTR/L)
- **Authorized official phone:** (419) 508-3996

## Contact information

- **Practice address:** 2624 ESPINOZA ST, TRINIDAD, CO 81082-3913
- **Practice address phone:** (419) 508-3996
- **Mailing address:** 2624 ESPINOZA ST, TRINIDAD, CO 81082-3913
- **Mailing address phone:** (419) 508-3996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | OT.0002493 | CO | Yes |

## Other

- **Enumeration date:** 11/14/2016
- **Last updated:** 11/14/2016