Healthcare Provider Details

I. General information

NPI: 1205474657
Provider Name (Legal Business Name): ANTHEM PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2019
Last Update Date: 10/01/2023
Certification Date: 10/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1826 E PLATTE AVE STE 114
COLORADO SPRINGS CO
80909-5738
US

IV. Provider business mailing address

10083 MANHATTAN DR
COLORADO SPRINGS CO
80924-7040
US

V. Phone/Fax

Practice location:
  • Phone: 719-645-5052
  • Fax: 720-419-3297
Mailing address:
  • Phone: 719-645-5052
  • Fax: 720-419-3297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL SEUBERT
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT, CERT. DN
Phone: 719-645-5052