Provider Demographics
NPI:1134829682
Name:VERTICAL MOTION PHYSICAL THERAPY
Entity type:Organization
Organization Name:VERTICAL MOTION PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-325-5329
Mailing Address - Street 1:32135 CASTLE CT STE 100A
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-8005
Mailing Address - Country:US
Mailing Address - Phone:303-325-5329
Mailing Address - Fax:303-672-3323
Practice Address - Street 1:98 12TH AVE
Practice Address - Street 2:
Practice Address - City:IDAHO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80452-5005
Practice Address - Country:US
Practice Address - Phone:303-325-5329
Practice Address - Fax:303-673-3323
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VERTICAL MOTION PHYSICAL THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000158729Medicaid