Provider Demographics
NPI:1376931683
Name:SYNERGY SPORTS AND REHAB LLC
Entity Type:Organization
Organization Name:SYNERGY SPORTS AND REHAB LLC
Other - Org Name:SYNERGY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:H
Authorized Official - Last Name:KATZOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:720-313-1585
Mailing Address - Street 1:12311 PINE BLUFFS WAY
Mailing Address - Street 2:UNIT J
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-4339
Mailing Address - Country:US
Mailing Address - Phone:720-313-1585
Mailing Address - Fax:
Practice Address - Street 1:12311 PINE BLUFFS WAY
Practice Address - Street 2:UNIT J
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4339
Practice Address - Country:US
Practice Address - Phone:720-313-1585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9159251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health