Organization
PHYSICAL THERAPY CONNECTIONS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHAD A. CLARK MSPT, CSCS (PHYSICAL THERAPIST, OWNER)
(719) 565-6678
Entity
Organization
Contact information
Practice address
58 GLEN ROYAL DR, PUEBLO, CO 81005-2174
(719) 565-6678
(719) 561-0577
Mailing address
58 GLEN ROYAL DR, PUEBLO, CO 81005-2263
(719) 565-6678
(719) 561-0577
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
5835
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36630233
—
CO
Enumeration date
03/29/2007
Last updated
01/10/2012
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