Healthcare Provider Details
I. General information
NPI: 1538914973
Provider Name (Legal Business Name): NTG REHAB
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/19/2024
Last Update Date: 06/02/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6005 DELMONICO DR STE 130
COLORADO SPRINGS CO
80919-2265
US
IV. Provider business mailing address
3025 ELECTRA DR
COLORADO SPRINGS CO
80906-1090
US
V. Phone/Fax
- Phone: 719-204-9293
- Fax:
- Phone: 719-249-0096
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
C
BUCKLER
Title or Position: CEO
Credential: PT
Phone: 719-492-0160