Provider Demographics
NPI:1225573801
Name:VISITING THERAPISTS, LLC
Entity Type:Organization
Organization Name:VISITING THERAPISTS, LLC
Other - Org Name:VISITING THERAPISTS OF COLORADO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENCY GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:IZZY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOZADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-658-5052
Mailing Address - Street 1:PO BOX 744
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-0744
Mailing Address - Country:US
Mailing Address - Phone:970-658-5052
Mailing Address - Fax:866-805-0383
Practice Address - Street 1:2219 STILLWATER CREEK DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-8513
Practice Address - Country:US
Practice Address - Phone:970-658-5052
Practice Address - Fax:866-805-0383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000139491OtherCOLORADO INTERCHANGE PROVIDER NUMBER