Provider Demographics
NPI:1831696988
Name:WEST END PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:WEST END PHYSICAL THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GROVER
Authorized Official - Middle Name:OLCOTT
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:970-327-4567
Mailing Address - Street 1:PO BOX 1124
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:81423-1124
Mailing Address - Country:US
Mailing Address - Phone:970-327-4567
Mailing Address - Fax:970-327-4574
Practice Address - Street 1:1110 LUCERNE ST.
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:CO
Practice Address - Zip Code:81423
Practice Address - Country:US
Practice Address - Phone:970-327-4567
Practice Address - Fax:970-327-4574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty