Provider Demographics
NPI:1598063158
Name:GALBREATH, RANDOLPH CORT (PT)
Entity Type:Individual
Prefix:MR
First Name:RANDOLPH
Middle Name:CORT
Last Name:GALBREATH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78001 BASALT RD.
Mailing Address - Street 2:
Mailing Address - City:CRAWFORD
Mailing Address - State:CO
Mailing Address - Zip Code:81415
Mailing Address - Country:US
Mailing Address - Phone:970-424-2536
Mailing Address - Fax:
Practice Address - Street 1:78001 BASALT RD
Practice Address - Street 2:
Practice Address - City:CRAWFORD
Practice Address - State:CO
Practice Address - Zip Code:81415-9407
Practice Address - Country:US
Practice Address - Phone:970-424-2536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist