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Organization

MY HEROES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GEORGE BRENT APPLEGATE MPT, HPCS (OWNER)
(678) 984-7774
Entity
Organization

Contact information

Practice address
725 S OVERLAND TRAIL, FORT COLLINS, CO 80523-1669
(678) 984-7774
(888) 551-6210
Mailing address
316 S WASHINGTON AVE, FORT COLLINS, CO 80521-2559
(678) 984-7774
(888) 551-6210

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
225X00000X
Occupational Therapist
261QP2000X
Physical Therapy Clinic/Center
PT007063
GA
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
148541482B
GA
01
52704274
BCBS OF GA PROVIDER ID
GA
Enumeration date
03/16/2007
Last updated
05/13/2024
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