Provider Demographics
NPI:1366126682
Name:PEARSON PHYSIOTHERAPY
Entity type:Organization
Organization Name:PEARSON PHYSIOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAYLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-826-4800
Mailing Address - Street 1:440 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2729
Mailing Address - Country:US
Mailing Address - Phone:970-326-8482
Mailing Address - Fax:970-826-4801
Practice Address - Street 1:440 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2729
Practice Address - Country:US
Practice Address - Phone:970-326-8482
Practice Address - Fax:970-826-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty