Steve Jackson Bollenbacher
Individual provider Active NPI Physical Therapist · Rifle, CO
NPI 1831678952 · NPPES record last updated Aug 9, 2018
Key facts
- NPI
- 1831678952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PTL.0015068 (CO)
- Practice address
- 851 E 5TH St
Rifle, CO 81650-2941 - Phone
- (970) 665-1041
- NPI assigned
- Aug 9, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL.0015068 | CO | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTL.0015068 | CO | Yes |
Addresses
Primary practice location
851 E 5TH St
Rifle, CO 81650-2941
Mailing address
PO Box 2460
Gypsum, CO 81637-2460
Other providers in Rifle, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.