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Organization

COLORADO ORTHOPEDIC REHABILITATION SPECIALIST, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRADLEY GENE SCHOONVELD MPT, MTC (PRESIDENT/OWNER)
(303) 457-2022
Entity
Organization

Contact information

Practice address
11325 N. COLORADO BLVD, THORNTON, CO 80233
(303) 457-2022
(303) 457-2320
Mailing address
11325 N. COLORADO BLVD, THORNTON, CO 80233
(303) 457-2022
(303) 457-2320

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
6712
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
28606264
CO
01
605038800
OWCP
CO
01
7238042
CIGNA
CO
01
SCSC6685
ANTHEM BLUE CROSS
CO
Enumeration date
01/29/2007
Last updated
08/17/2016
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