Organization
AT HOME REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LEANORA THERESA PREMEAU M.P.T. (PHYSICAL THERAPIST)
(719) 539-2431
Entity
Organization
Contact information
Practice address
731 BLAKE ST, SALIDA, CO 81201-2919
(719) 539-2431
(719) 539-3626
Mailing address
416 E 4TH ST, SALIDA, CO 81201-2822
(719) 539-2431
(719) 539-3626
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
6910
CO
Other
Enumeration date
05/22/2006
Last updated
08/15/2007
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