Provider Demographics
NPI:1932063120
Name:AQUA DYNAMICS PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:AQUA DYNAMICS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:KRISTINE
Authorized Official - Last Name:RANTANEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:970-449-0832
Mailing Address - Street 1:320 W 37TH STREET
Mailing Address - Street 2:SUITE #336
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538
Mailing Address - Country:US
Mailing Address - Phone:970-449-9536
Mailing Address - Fax:970-372-2772
Practice Address - Street 1:1015 W HORSETOOTH RD
Practice Address - Street 2:SUITE #103
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526
Practice Address - Country:US
Practice Address - Phone:970-449-0832
Practice Address - Fax:970-372-2772
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AQUA DYNAMICS PHYSICAL THERAPY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-12-11
Last Update Date:2025-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000221160Medicaid