Organization
START ACTIVE RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN SUE CUSTER PTA (OWNER/FOUNDER)
(720) 272-8417
Entity
Organization
Contact information
Practice address
13701 W JEWELL AVE STE 113, LAKEWOOD, CO 80228-4172
(720) 272-8417
Mailing address
13701 W JEWELL AVE STE 113, LAKEWOOD, CO 80228-4172
(720) 272-8417
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/01/2020
Last updated
10/01/2020
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