Provider Demographics
NPI:1427731819
Name:BLUEBIRD THERAPY AND WELLNESS
Entity type:Organization
Organization Name:BLUEBIRD THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEVRIER
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:248-462-3804
Mailing Address - Street 1:8369 E LOWRY BLVD APT 303
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7135
Mailing Address - Country:US
Mailing Address - Phone:720-780-1145
Mailing Address - Fax:
Practice Address - Street 1:8369 E LOWRY BLVD APT 303
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7135
Practice Address - Country:US
Practice Address - Phone:720-780-1145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation