Provider Demographics
NPI:1063630556
Name:WETTE INTEGRATIVE THERAPY, INC
Entity Type:Organization
Organization Name:WETTE INTEGRATIVE THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:WETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:970-282-3751
Mailing Address - Street 1:107 PETERSON ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-2917
Mailing Address - Country:US
Mailing Address - Phone:970-282-3751
Mailing Address - Fax:970-282-3720
Practice Address - Street 1:107 PETERSON ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2917
Practice Address - Country:US
Practice Address - Phone:970-282-3751
Practice Address - Fax:970-282-3720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4807225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC465178Medicare PIN