Healthcare Provider Details

I. General information

NPI: 1306773502
Provider Name (Legal Business Name): COLIN O'BANION PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 FRONTIER AVE STE D
BOULDER CO
80301-2430
US

IV. Provider business mailing address

1110 EDINBORO DR
BOULDER CO
80305-6430
US

V. Phone/Fax

Practice location:
  • Phone: 928-600-4886
  • Fax:
Mailing address:
  • Phone: 928-600-4886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: COLIN O'BANION
Title or Position: DPT, OWNER
Credential: PT
Phone: 928-600-4886