| Edward M. Kennedy Physical Therapy | |
|
925 2nd Ave Monte Vista CO 81144-1432 | |
| (719) 852-7081 | |
| (719) 587-1543 |
| Full Name | Edward M. Kennedy Physical Therapy |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 925 2nd Ave, Monte Vista, Colorado |
| Authorized Official Name and Position | Jania Arnoldi (PRESIDENT/CEO) |
| Authorized Official Contact | 7195895161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward M. Kennedy Physical Therapy 128 Market St Alamosa CO 81101-2290 Ph: (719) 587-1001 | Edward M. Kennedy Physical Therapy 925 2nd Ave Monte Vista CO 81144-1432 Ph: (719) 852-7081 |
| NPI Number | 1154303758 |
|---|---|
| Provider Enumeration Date | 11/18/2005 |
| Last Update Date | 05/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154303758 | NPI | - | NPPES |
| 56836074 | Medicaid | CO | |
| CE 9669 | Other | CO | TRAVELERS MEDICARE |
| VAC4808 | Other | CO | ANTHEM BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Colorado) | Primary |
| 261QR0400X | Clinic/center - Rehabilitation | (Colorado) | Secondary |
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