Organization
CUCHARA VALLEY PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE MARIE KOUTNIK P.T. (OWNER)
(719) 738-3160
Entity
Organization
Contact information
Practice address
125 E 5TH ST, WALSENBURG, CO 81089-2009
(719) 738-3160
(719) 738-3170
Mailing address
125 E 5TH ST, WALSENBURG, CO 81089-2020
(719) 738-3160
(719) 738-3170
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87650886
—
CO
Enumeration date
10/11/2006
Last updated
07/21/2022
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