Provider Demographics
NPI:1649597477
Name:PEARSON PHYSIOTHERAPY SPECIALISTS, LLC
Entity Type:Organization
Organization Name:PEARSON PHYSIOTHERAPY SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:970-629-3656
Mailing Address - Street 1:440 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2729
Mailing Address - Country:US
Mailing Address - Phone:970-629-3656
Mailing Address - Fax:
Practice Address - Street 1:440 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2729
Practice Address - Country:US
Practice Address - Phone:970-629-3656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty