Healthcare Provider Details

I. General information

NPI: 1114158946
Provider Name (Legal Business Name): PHYSIOWORKS PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 09/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1831 AUSTIN BLUFFS PKWY STE 100
COLORADO SPRINGS CO
80918-7847
US

IV. Provider business mailing address

1831 AUSTIN BLUFFS PKWY STE 100
COLORADO SPRINGS CO
80918-7847
US

V. Phone/Fax

Practice location:
  • Phone: 719-599-8550
  • Fax: 719-218-9200
Mailing address:
  • Phone: 719-599-8550
  • Fax: 719-218-9200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2755
License Number StateCO

VIII. Authorized Official

Name: ROBERT E HOLTBY
Title or Position: OWNER
Credential: MA PT
Phone: 719-495-2830