Most Relevant Information
Provider Data
| NPI Number: | 1003438094 |
| Provider Name: | BRET CORY BISHOP PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | PTA.0014491 |
Most Important Dates
| Enumeration Date: | 05/12/2020 |
| Last Updated: | 05/12/2020 |
Provider Practice Location
3727 PARKER BLVD
PUEBLO
CO
810082218
Practice Location Phone/Fax
| Phone: | 7195844000 |
| Fax: |
Provider Mailing Location
113 COMANCHE CT
FOUNTAIN
CO
808171693
Provider Mailing Phone/Fax
| Phone: | 4353100841 |
| Fax: |