Healthcare Provider Details

I. General information

NPI: 1245199710
Provider Name (Legal Business Name): CS COLORADO CLINICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 N CIRCLE DR STE 120
COLORADO SPRINGS CO
80909-1182
US

IV. Provider business mailing address

3010 N CIRCLE DR STE 120
COLORADO SPRINGS CO
80909-1182
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-4888
  • Fax: 719-776-4860
Mailing address:
  • Phone: 719-776-4888
  • Fax: 719-776-4860

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: MR. GLENN PESHEK
Title or Position: ASSOCIATE ADMINISTRATOR OMA
Credential:
Phone: 303-673-7164