Provider Demographics
NPI:1184355794
Name:COLORADO PRO HEALTH REHAB-KIDS & ADULTS LLC
Entity type:Organization
Organization Name:COLORADO PRO HEALTH REHAB-KIDS & ADULTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SALOB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-781-6467
Mailing Address - Street 1:685 CITADEL DR E STE 669
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5453
Mailing Address - Country:US
Mailing Address - Phone:719-597-6241
Mailing Address - Fax:719-698-9944
Practice Address - Street 1:685 CITADEL DR E STE 669
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5453
Practice Address - Country:US
Practice Address - Phone:719-597-6241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty