Provider Demographics
NPI:1144373523
Name:MCAWARD PHYSICAL THERAPY P.C.
Entity type:Organization
Organization Name:MCAWARD PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:MCAWARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:970-247-8168
Mailing Address - Street 1:129 COUNTY ROAD 250
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-8530
Mailing Address - Country:US
Mailing Address - Phone:970-259-9366
Mailing Address - Fax:970-259-9367
Practice Address - Street 1:129 COUNTY ROAD 250
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-8530
Practice Address - Country:US
Practice Address - Phone:970-259-9366
Practice Address - Fax:970-259-9367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2702225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty