Healthcare Provider Details

I. General information

NPI: 1265755789
Provider Name (Legal Business Name): AMY PIHLSTROM PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY ELIZABETH AGNEW PT

II. Dates (important events)

Enumeration Date: 03/11/2010
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6385 CORPORATE DR STE 100
COLORADO SPRINGS CO
80919-5912
US

IV. Provider business mailing address

125 N PARKSIDE DR SUITE 201
COLORADO SPRINGS CO
80909-6097
US

V. Phone/Fax

Practice location:
  • Phone: 719-380-1100
  • Fax:
Mailing address:
  • Phone: 719-785-3722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number2556
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: