Provider Demographics
NPI:1386614048
Name:MOUNTAIN VIEW PHYSICAL THERAPY
Entity type:Organization
Organization Name:MOUNTAIN VIEW PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:GLUTH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:303-674-7889
Mailing Address - Street 1:1262 BERGEN PKWY
Mailing Address - Street 2:E10
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-9546
Mailing Address - Country:US
Mailing Address - Phone:303-674-7889
Mailing Address - Fax:303-674-8117
Practice Address - Street 1:1262 BERGEN PKWY
Practice Address - Street 2:E10
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-9546
Practice Address - Country:US
Practice Address - Phone:303-674-7889
Practice Address - Fax:303-674-8117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCP6203Medicare ID - Type Unspecified