Organization Name: | CHILDREN'S HOSPITAL COLORADO |
NPI Number: | 1003264912 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JACQUELINE THERRIEN (PHYSICAL THERAPIST) |
Mailing Address: | 175 S Union Blvd 255 Colorado Springs |
State: | CO US |
Postal Code: | 809103113 |
Phone Number: | 7193058109 |
Fax Number: | |
NPI Enumeration Date: | 06/01/2016 |
NPI Last Update Date: | 06/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | PTL.0013449 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |