Provider Demographics
NPI:1659838191
Name:DIRECT ACCESS PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:DIRECT ACCESS PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:L
Authorized Official - Last Name:BREMNER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:970-549-2176
Mailing Address - Street 1:2482 PATTERSON RD UNIT 100
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-3601
Mailing Address - Country:US
Mailing Address - Phone:970-549-2176
Mailing Address - Fax:970-216-0034
Practice Address - Street 1:2482 PATTERSON RD UNIT 100
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-3601
Practice Address - Country:US
Practice Address - Phone:970-549-2176
Practice Address - Fax:970-216-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy