Provider Demographics
NPI:1104983071
Name:COLUMBINE HAND THERAPY
Entity type:Organization
Organization Name:COLUMBINE HAND THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNEES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-650-6878
Mailing Address - Street 1:80 GARDEN CTR
Mailing Address - Street 2:BLDG A, STE 104
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7087
Mailing Address - Country:US
Mailing Address - Phone:720-887-3637
Mailing Address - Fax:720-887-3634
Practice Address - Street 1:80 GARDEN CTR
Practice Address - Street 2:BLDG A, STE 104
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7087
Practice Address - Country:US
Practice Address - Phone:720-887-3637
Practice Address - Fax:720-887-3634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07026362Medicaid
CO066632Medicare PIN
CO0933910001Medicare NSC
COC808192Medicare PIN