Organization Name: | TAKE CHARGE PHYSICAL THERAPY, PLLC |
NPI Number: | 1154662591 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KANDRA KAY LOVATO (PHYSICAL THERAPIST/OWNER) |
Mailing Address: | 325 Second St Ste O Monument |
State: | CO US |
Postal Code: | 801327935 |
Phone Number: | 7194813747 |
Fax Number: | 7194886547 |
NPI Enumeration Date: | 03/11/2013 |
NPI Last Update Date: | 03/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 2201 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |