Organization
COLORADO OCCUPATIONAL AND LYMPHEDEMA THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J E FYFFE (OTR/L)
(419) 508-3996
Entity
Organization
Contact information
Practice address
2624 ESPINOZA ST, TRINIDAD, CO 81082-3913
(419) 508-3996
Mailing address
2624 ESPINOZA ST, TRINIDAD, CO 81082-3913
(419) 508-3996
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
OT.0002493
CO
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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