Provider Demographics
NPI:1679804256
Name:PARKER PHYSICAL THERAPY & REHAB SERVICES, INC
Entity Type:Organization
Organization Name:PARKER PHYSICAL THERAPY & REHAB SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:719-486-2000
Mailing Address - Street 1:PO BOX 505
Mailing Address - Street 2:
Mailing Address - City:LEADVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80461-0505
Mailing Address - Country:US
Mailing Address - Phone:719-486-2000
Mailing Address - Fax:719-486-2001
Practice Address - Street 1:1601 POPLAR ST
Practice Address - Street 2:
Practice Address - City:LEADVILLE
Practice Address - State:CO
Practice Address - Zip Code:80461-3059
Practice Address - Country:US
Practice Address - Phone:719-486-2000
Practice Address - Fax:719-486-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3404261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy