Organization
PHYSIOM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANDEL SCHRODER (BILLING AGENT)
(303) 922-4636
Entity
Organization
Contact information
Practice address
1300 OAKRIDGE DR, 130, FORT COLLINS, CO 80525-5564
(970) 377-9555
(970) 377-9559
Mailing address
PHYSIOM LLC DEPT 2089, DENVER, CO 80291-0001
(303) 922-4636
(303) 922-4640
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
31928
CO
Other
Enumeration date
12/18/2008
Last updated
12/18/2008
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