Provider Demographics
| NPI: | 1962148817 |
|---|---|
| Name: | COLORADO IN MOTION LLC |
| Entity type: | Organization |
| Organization Name: | COLORADO IN MOTION LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | TERRY |
| Authorized Official - Middle Name: | LEE |
| Authorized Official - Last Name: | GEBHARDT |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 970-221-1201 |
| Mailing Address - Street 1: | 175 S ENGLISH STATION RD STE 218 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | LOUISVILLE |
| Mailing Address - State: | KY |
| Mailing Address - Zip Code: | 40245-4199 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 812-759-7451 |
| Mailing Address - Fax: | 812-759-7482 |
| Practice Address - Street 1: | 331 HICKORY ST STE 130 |
| Practice Address - Street 2: | |
| Practice Address - City: | FORT COLLINS |
| Practice Address - State: | CO |
| Practice Address - Zip Code: | 80524-1138 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 970-221-1201 |
| Practice Address - Fax: | 800-675-0273 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2022-05-12 |
| Last Update Date: | 2022-05-12 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Single Specialty |