Provider Demographics
NPI:1336510593
Name:HARBOUR, ERIC CO (ATC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:CO
Last Name:HARBOUR
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 W 10TH AVE
Mailing Address - Street 2:APT 3A
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-4235
Mailing Address - Country:US
Mailing Address - Phone:248-766-4465
Mailing Address - Fax:
Practice Address - Street 1:LOVELAND SKI CLUB
Practice Address - Street 2:EXIT 216, INTERSTATE 70
Practice Address - City:GEORGETOWN
Practice Address - State:CO
Practice Address - Zip Code:80444
Practice Address - Country:US
Practice Address - Phone:248-766-4465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2000013842226300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist