Provider Demographics
NPI:1154141943
Name:COLORADO PHYSIO CLINIC LLC
Entity type:Organization
Organization Name:COLORADO PHYSIO CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAURAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-713-8216
Mailing Address - Street 1:10028 HEATHERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-7888
Mailing Address - Country:US
Mailing Address - Phone:224-713-8216
Mailing Address - Fax:
Practice Address - Street 1:1175 S PERRY ST STE 140
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1969
Practice Address - Country:US
Practice Address - Phone:224-713-8216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty