Provider Demographics
NPI:1376260869
Name:PT COACH PLLC
Entity Type:Organization
Organization Name:PT COACH PLLC
Other - Org Name:RV PT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:786-251-7786
Mailing Address - Street 1:1360 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-4773
Mailing Address - Country:US
Mailing Address - Phone:786-251-7786
Mailing Address - Fax:855-595-2510
Practice Address - Street 1:7960 NIWOT RD UNIT B9
Practice Address - Street 2:
Practice Address - City:NIWOT
Practice Address - State:CO
Practice Address - Zip Code:80503-7151
Practice Address - Country:US
Practice Address - Phone:786-251-7786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1023060555OtherNPI