Provider Demographics
NPI:1790013001
Name:ROCKY MOUNTAIN PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN PHYSICAL THERAPY, INC
Other - Org Name:ROCKY MOUNTAIN PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTOFF
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:724-223-2061
Mailing Address - Street 1:2121 E HARMONY RD UNIT 310
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3403
Mailing Address - Country:US
Mailing Address - Phone:970-689-3236
Mailing Address - Fax:970-460-0136
Practice Address - Street 1:1159 MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-4700
Practice Address - Country:US
Practice Address - Phone:970-460-0066
Practice Address - Fax:970-460-0136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9941225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOB4918OtherMEDICARE GROUP PTAN