Provider Demographics
NPI:1174304968
Name:COLORADO ORTHOPEDIC REHABILITATION SPECIALIST, LLC
Entity type:Organization
Organization Name:COLORADO ORTHOPEDIC REHABILITATION SPECIALIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:SCHOONVELD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:303-457-2022
Mailing Address - Street 1:11325 COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-2601
Mailing Address - Country:US
Mailing Address - Phone:303-457-2022
Mailing Address - Fax:303-457-2320
Practice Address - Street 1:11325 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-2601
Practice Address - Country:US
Practice Address - Phone:303-457-2022
Practice Address - Fax:303-457-2320
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CPTN PRIME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty