Provider Demographics
NPI:1902207863
Name:THERAPYDIA COLORADO, INC.
Entity Type:Organization
Organization Name:THERAPYDIA COLORADO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMKIW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-822-8274
Mailing Address - Street 1:18 E BLITHEDALE AVE
Mailing Address - Street 2:SUITE 21
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1908
Mailing Address - Country:US
Mailing Address - Phone:415-389-8677
Mailing Address - Fax:
Practice Address - Street 1:1727 15TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-6341
Practice Address - Country:US
Practice Address - Phone:760-822-8274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy