Organization
FULLSWIFT PHYSIOTHERAPY , PLLC
Active
Other names
Craft Physiotherapy & Sports Performance Training
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE RUSSELL MICKLEY MODICA P.T. (OWNER, DOCTOR OF PHYSICAL THERAPY)
(720) 771-1159
Entity
Organization
Contact information
Practice address
538 W. LAUREL CT., LOUISVILLE, CO 80027
(720) 771-1159
Mailing address
538 W. LAUREL CT., LOUISVILLE, CO 80027
(720) 771-1159
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
04/11/2020
Last updated
04/11/2020
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