Provider Demographics
NPI:1447560495
Name:REBOUND THERAPY AND WELLNESS CLINIC INC
Entity Type:Organization
Organization Name:REBOUND THERAPY AND WELLNESS CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DJIMMER
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:303-689-2222
Mailing Address - Street 1:8101 E BELLEVIEW AVE
Mailing Address - Street 2:A-80
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2903
Mailing Address - Country:US
Mailing Address - Phone:303-689-2222
Mailing Address - Fax:303-773-0804
Practice Address - Street 1:8101 E BELLEVIEW AVE
Practice Address - Street 2:A-80
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-2903
Practice Address - Country:US
Practice Address - Phone:303-689-2222
Practice Address - Fax:303-773-0804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37782251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty