Healthcare Provider Details
I. General information
NPI: 1386202976
Provider Name (Legal Business Name): NICHOLAS PAUL WOHKITTEL PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/30/2019
Last Update Date: 07/05/2023
Certification Date: 02/26/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6140 TUTT BLVD STE 110
COLORADO SPRINGS CO
80923-3577
US
IV. Provider business mailing address
4110 BRIARGATE PKWY STE 300
COLORADO SPRINGS CO
80920-7837
US
V. Phone/Fax
- Phone: 719-632-7669
- Fax: 719-632-0088
- Phone: 719-632-7669
- Fax: 719-632-0088
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: