Healthcare Provider Details
I. General information
NPI: 1386626984
Provider Name (Legal Business Name): JEANNINE BEAUMONT LAFORCE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 11/18/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1330 QUAIL LAKE LOOP SUITE 100 PT WORKS CHEYENNE MOUNTAIN CLINIC
COLORADO SPRINGS CO
80906-4651
US
IV. Provider business mailing address
1330 QUAIL LAKE LOOP SUITE 100 PT WORKS PC CHEYENNE MOUNTAIN CLINIC
COLORADO SPRINGS CO
80906-4651
US
V. Phone/Fax
- Phone: 719-579-0230
- Fax: 719-579-0277
- Phone: 719-579-0230
- Fax: 719-579-0277
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | CO6362 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT17204 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251S0007X |
| Taxonomy | Sports Physical Therapist |
| License Number | CO6362 |
| License Number State | CO |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | CO6362 |
| License Number State | CO |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | CO6362 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: