Provider Demographics
NPI:1679798912
Name:MAKE THE CONNECTION LLC
Entity Type:Organization
Organization Name:MAKE THE CONNECTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:SWITZER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:720-352-7532
Mailing Address - Street 1:PO BOX 21150
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80308-4150
Mailing Address - Country:US
Mailing Address - Phone:303-546-9158
Mailing Address - Fax:303-546-9107
Practice Address - Street 1:5277 MANHATTAN CIR
Practice Address - Street 2:STE 103
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-8201
Practice Address - Country:US
Practice Address - Phone:720-352-7532
Practice Address - Fax:303-664-1778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5608225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC802056Medicare PIN