Provider Demographics
NPI:1265170278
Name:SYNERGY THERAPY SERVICES
Entity type:Organization
Organization Name:SYNERGY THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPT
Authorized Official - Prefix:
Authorized Official - First Name:KELLEE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BRUDOS-NOCKELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-232-8443
Mailing Address - Street 1:19039 W 88TH DR
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-7302
Mailing Address - Country:US
Mailing Address - Phone:720-232-8443
Mailing Address - Fax:303-467-2866
Practice Address - Street 1:19039 W 88TH DR
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80007-7302
Practice Address - Country:US
Practice Address - Phone:720-232-8443
Practice Address - Fax:303-467-2866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1932349552Medicaid