Healthcare Provider Details

I. General information

NPI: 1538951918
Provider Name (Legal Business Name): REBECCA ANN SKIDMORE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2322 S ACADEMY BLVD
COLORADO SPRINGS CO
80916-2406
US

IV. Provider business mailing address

3645 RIALTO HTS APT 329
COLORADO SPRINGS CO
80907-8646
US

V. Phone/Fax

Practice location:
  • Phone: 719-390-1727
  • Fax:
Mailing address:
  • Phone: 614-579-6811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0020579
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: