Healthcare Provider Details

I. General information

NPI: 1558036210
Provider Name (Legal Business Name): KORY JAMES LANDERS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 RESEARCH PKWY STE 100
COLORADO SPRINGS CO
80920-1093
US

IV. Provider business mailing address

8101 E LOWRY BLVD STE 120
DENVER CO
80230-7195
US

V. Phone/Fax

Practice location:
  • Phone: 719-623-1050
  • Fax:
Mailing address:
  • Phone: 720-865-6072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT5921
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT5921
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: