Provider Demographics
NPI:1427390558
Name:PHYSIO ONE LTD
Entity Type:Organization
Organization Name:PHYSIO ONE LTD
Other - Org Name:ACK PT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARBOUR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:970-404-0758
Mailing Address - Street 1:46 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02554-2272
Mailing Address - Country:US
Mailing Address - Phone:970-404-0758
Mailing Address - Fax:
Practice Address - Street 1:46 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-2272
Practice Address - Country:US
Practice Address - Phone:970-404-0758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18005261QP2000X
CO6714261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy