Healthcare Provider Details

I. General information

NPI: 1487596029
Provider Name (Legal Business Name): MOUNTAIN TIME PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4491 BENT BROTHERS BLVD SUITE B
COLORADO CITY CO
81019
US

IV. Provider business mailing address

PO BOX 548
LA VETA CO
81055-0548
US

V. Phone/Fax

Practice location:
  • Phone: 719-988-2839
  • Fax: 719-425-3417
Mailing address:
  • Phone: 718-988-2839
  • Fax: 719-425-3417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANDREW C SLIFKO
Title or Position: PRESIDENT
Credential: PT, DPT
Phone: 412-760-0535