Healthcare Provider Details

I. General information

NPI: 1265615074
Provider Name (Legal Business Name): PETER A WINN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2007
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5176 GANSEVOORT DR STE A
COLORADO SPRINGS CO
80924-5391
US

IV. Provider business mailing address

5176 GANSEVOORT DR
COLORADO SPRINGS CO
80924-5391
US

V. Phone/Fax

Practice location:
  • Phone: 719-623-6663
  • Fax:
Mailing address:
  • Phone: 719-623-6663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0019236
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: