Organization
EXECUTIVE PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLINE CORNING CREAGER PT (OWNER)
(970) 532-2533
Entity
Organization
Contact information
Practice address
247 MOUNTAIN AVENUE, BERTHOUD, CO 80513
(970) 532-2533
(970) 532-5450
Mailing address
PO BOX 1319, BERTHOUD, CO 80513-2319
(970) 532-2533
(970) 532-5450
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
3219
CO
Other
Enumeration date
03/11/2008
Last updated
03/11/2008
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