Organization
FRONT RANGE THERAPIES CASTLE ROCK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY BERNACKI PT (OWNER)
(303) 688-5885
Entity
Organization
Contact information
Practice address
1025 SOUTH PERRY STREET, #101, CASTLE ROCK, CO 80104
(303) 688-5885
(303) 688-5903
Mailing address
1025 SOUTH PERRY STREET, #101, CASTLE ROCK, CO 80104
(303) 688-5885
(303) 688-5903
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001 3059
ROCKY MOUNTAIN HEALTHPLAN
CO
01
—
611202500
DEPT OF LABOR
CO
01
—
FR675117
BCBS/ANTHEM
CO
Enumeration date
07/06/2006
Last updated
06/24/2014
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