Healthcare Provider Details

I. General information

NPI: 1659836633
Provider Name (Legal Business Name): OPTIMUM THERAPY AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2019
Last Update Date: 02/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 N ACADEMY BLVD
COLORADO SPRINGS CO
80909-1567
US

IV. Provider business mailing address

6349 FARTHING DR
COLORADO SPRINGS CO
80906-7504
US

V. Phone/Fax

Practice location:
  • Phone: 913-269-6120
  • Fax: 719-219-2321
Mailing address:
  • Phone: 913-269-6120
  • Fax:

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. ERIN MARIE SLIVKA
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 913-269-6120