Provider Demographics
NPI:1609344290
Name:APEX PHYSICAL MEDICINE AND REHABILITATION PROFESSIONAL LLC
Entity type:Organization
Organization Name:APEX PHYSICAL MEDICINE AND REHABILITATION PROFESSIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:BISSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-635-3764
Mailing Address - Street 1:3910 S CAREFREE CIR STE F
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-3053
Mailing Address - Country:US
Mailing Address - Phone:719-635-3764
Mailing Address - Fax:719-635-7593
Practice Address - Street 1:3910 S CAREFREE CIR STE F
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-3053
Practice Address - Country:US
Practice Address - Phone:719-635-3764
Practice Address - Fax:719-635-7593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-13
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory