1831532696 NPI number — MCGRATH THERAPY AND CONSULTING LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831532696 NPI number — MCGRATH THERAPY AND CONSULTING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCGRATH THERAPY AND CONSULTING LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831532696
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
912 SANDY COVE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT COLLINS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80525-3325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-430-6397
Provider Business Mailing Address Fax Number:
970-797-2311

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4115 BOARDWALK DR
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
FORT COLLINS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80525-5945
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-430-6397
Provider Business Practice Location Address Fax Number:
970-797-2311
Provider Enumeration Date:
04/11/2013

Additional Information

Authorized Official

Authorized Official Last Name:
MCGRATH
Authorized Official First Name:
RANDALL
Authorized Official Middle Name:
THOMAS
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
970-430-6397

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  0012698 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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