MEDICARE: MR. DAVID B FIELD PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PTL0010615	CO

General Provider Information

NPI Number	:	1831204056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID B FIELD PT

Provider Business Mailing Address
First Line	:	442 GOLD CLAIM TER
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-4201
Country	:	US
Telephone Number	:	251-581-2223
Fax Number	:

Provider Business Practice Location Address
First Line	:	1775 S 8TH ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-1926
Country	:	US
Telephone Number	:	719-477-6870
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	03/12/2013

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