Healthcare Provider Details

I. General information

NPI: 1538844469
Provider Name (Legal Business Name): PHENIX THERAPIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2023
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2844 JANITELL RD STE A
COLORADO SPRINGS CO
80906-4141
US

IV. Provider business mailing address

1625 MEDICAL CENTER PT
COLORADO SPRINGS CO
80907-8731
US

V. Phone/Fax

Practice location:
  • Phone: 719-344-9497
  • Fax: 719-358-6042
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: SHENTELL GUY
Title or Position: ADMIN
Credential:
Phone: 719-344-9497