Organization
PINE RIVER PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD MOONEY (OFFICE MANAGER)
(970) 903-8895
Entity
Organization
Contact information
Practice address
480 WOLVERINE DR STE 5, BAYFIELD, CO 81122-9653
(970) 884-2956
Mailing address
480 WOLVERINE DR STE 5, BAYFIELD, CO 81122-9653
(970) 884-2956
(844) 269-9483
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16780051
—
CO
Enumeration date
04/17/2015
Last updated
05/11/2020
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