Provider Demographics
NPI:1194802520
Name:SCHILLING PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:SCHILLING PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:SCHILLING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:970-484-0400
Mailing Address - Street 1:1015 S LEMAY AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3913
Mailing Address - Country:US
Mailing Address - Phone:970-484-0400
Mailing Address - Fax:970-484-0433
Practice Address - Street 1:1015 S LEMAY AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3913
Practice Address - Country:US
Practice Address - Phone:970-484-0400
Practice Address - Fax:970-484-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5189225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO487938Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER