Provider Demographics
NPI:1144414152
Name:SHANNON ZELENKA PHYSIOTHERAPY INC
Entity Type:Organization
Organization Name:SHANNON ZELENKA PHYSIOTHERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ZELENKA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:970-309-4706
Mailing Address - Street 1:PO BOX 2105
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-2105
Mailing Address - Country:US
Mailing Address - Phone:970-309-4706
Mailing Address - Fax:970-704-6834
Practice Address - Street 1:900 COOPER AVENUE
Practice Address - Street 2:SUITE A
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-3666
Practice Address - Country:US
Practice Address - Phone:970-309-4706
Practice Address - Fax:970-704-6834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-02
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty