Organization
COLORADO REHABILITATION PHYS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILLIE SHELTON (BUSINESS OFFICE MANAGER)
(719) 776-5673
Entity
Organization
Contact information
Practice address
2222 N NEVADA AVE, STE 5020, COLORADO SPGS, CO 80907-6868
(719) 776-5960
(719) 776-5045
Mailing address
2222 N NEVADA AVE, STE 5020, COLORADO SPGS, CO 80907-6868
(719) 776-5960
(719) 776-5045
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71151753
—
CO
Enumeration date
05/15/2006
Last updated
03/19/2008
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