Provider Demographics
NPI:1114296068
Name:NEUROMUSCULAR STRATEGIES LLC
Entity Type:Organization
Organization Name:NEUROMUSCULAR STRATEGIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:KOHM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:720-352-0678
Mailing Address - Street 1:115 MONARCH CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1242
Mailing Address - Country:US
Mailing Address - Phone:720-352-0678
Mailing Address - Fax:
Practice Address - Street 1:4710 TABLE MESA DR STE B
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-4504
Practice Address - Country:US
Practice Address - Phone:720-350-0678
Practice Address - Fax:720-441-0485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5050261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOAAA3546OtherPTAN #