Provider Demographics
NPI:1912243833
Name:PROACTIVE SOLUTIONS,INC.
Entity Type:Organization
Organization Name:PROACTIVE SOLUTIONS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUDY
Authorized Official - Middle Name:JOSEF
Authorized Official - Last Name:HABERZETTL
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT, CEES
Authorized Official - Phone:719-310-1741
Mailing Address - Street 1:1441 FIELDWOOD CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-5635
Mailing Address - Country:US
Mailing Address - Phone:719-310-1741
Mailing Address - Fax:719-533-8188
Practice Address - Street 1:1441 FIELDWOOD CT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-5635
Practice Address - Country:US
Practice Address - Phone:719-310-1741
Practice Address - Fax:719-533-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-20
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8876225100000X
AZ7620PT225100000X
FL25790225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty