Provider Demographics
NPI:1275399511
Name:RESILIENT PHYSICAL THERAPY AND PERFORMANCE LLC
Entity Type:Organization
Organization Name:RESILIENT PHYSICAL THERAPY AND PERFORMANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICAELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DLUGOSZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:720-891-9728
Mailing Address - Street 1:56295 E 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:CO
Mailing Address - Zip Code:80136-7562
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:56295 E 25TH AVE
Practice Address - Street 2:
Practice Address - City:STRASBURG
Practice Address - State:CO
Practice Address - Zip Code:80136-7562
Practice Address - Country:US
Practice Address - Phone:720-891-9728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty