Organization
GAIA PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE HAVICE CONLIN M.P.T. (PHYSICAL THERAPIST OWNER)
(970) 302-4322
Entity
Organization
Contact information
Practice address
1919 65TH AVE, SUITE #3, GREELEY, CO 80634
(970) 302-4322
(888) 432-0938
Mailing address
1919 65TH AVE STE COFFICE2, GREELEY, CO 80634-7965
(970) 302-4322
(888) 432-0938
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6380
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10776231
—
CO
Enumeration date
11/08/2010
Last updated
07/16/2018
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