Healthcare Provider Details

I. General information

NPI: 1699958306
Provider Name (Legal Business Name): PELVIC THERAPY SPECIALISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 BASELINE RD STE 260
BOULDER CO
80303-2675
US

IV. Provider business mailing address

4770 BASELINE RD STE 260
BOULDER CO
80303-2675
US

V. Phone/Fax

Practice location:
  • Phone: 303-601-7495
  • Fax:
Mailing address:
  • Phone: 303-601-7495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number8348
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SANDRA KAY SHEVLIN
Title or Position: PRESIDENT/CEO
Credential: DPT
Phone: 303-601-7495