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Organization

HOLISTIC PHYSICAL THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELE ELISE KREISBERG PT (OWNER)
(720) 226-1448
Entity
Organization

Contact information

Practice address
3010 14TH ST, BOULDER, CO 80304-2610
(720) 226-1448
Mailing address
PO BOX 21150, BOULDER, CO 80308-4150
(303) 546-9158
(303) 546-9107

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7232
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C806277
MEDICARE PTAN
CO
01
HO675746
BCBS
CO
Enumeration date
05/05/2006
Last updated
01/30/2008
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