Provider Demographics
NPI:1477150597
Name:ANCHOR PHYSICAL THERAPY & WELLNESS, PLLC
Entity Type:Organization
Organization Name:ANCHOR PHYSICAL THERAPY & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MICKLICH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:719-580-4076
Mailing Address - Street 1:1020 NANCY ST
Mailing Address - Street 2:
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-3726
Mailing Address - Country:US
Mailing Address - Phone:719-580-4076
Mailing Address - Fax:
Practice Address - Street 1:1020 NANCY ST
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3726
Practice Address - Country:US
Practice Address - Phone:719-580-4076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy