Healthcare Provider Details

I. General information

NPI: 1801907662
Provider Name (Legal Business Name): ORTHOPEDIC REHABILITATION ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 AUSTIN BLUFFS PKWY
COLORADO SPRINGS CO
80918-6630
US

IV. Provider business mailing address

3605 AUSTIN BLUFFS PKWY
COLORADO SPRINGS CO
80918-6630
US

V. Phone/Fax

Practice location:
  • Phone: 719-265-6601
  • Fax: 719-265-6649
Mailing address:
  • Phone: 719-265-6601
  • Fax: 719-265-6649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL PAUL FOGARTY
Title or Position: OWNER PHYSICAL THERAPIST
Credential: MPT
Phone: 719-265-6601