Healthcare Provider Details

I. General information

NPI: 1164903761
Provider Name (Legal Business Name): TONYA FREEZE ED.S., LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TONYA SPILLER

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4925 N NEVADA SUITE 102
COLORADO SPRINGS CO
80918
US

IV. Provider business mailing address

4925 N NEVADA
COLORADO SPRINGS CO
80918
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-7846
  • Fax:
Mailing address:
  • Phone: 253-266-3176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberMSAT.0000008
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: