Healthcare Provider Details

I. General information

NPI: 1558818849
Provider Name (Legal Business Name): ZACHARY DEAN HARMON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2016
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3854 VILLAGE SEVEN RD
COLORADO SPRINGS CO
80917-2801
US

IV. Provider business mailing address

1020 ROBBIE VW APT 2126
COLORADO SPRINGS CO
80920-8227
US

V. Phone/Fax

Practice location:
  • Phone: 719-574-8761
  • Fax: 719-574-8236
Mailing address:
  • Phone: 970-691-7828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number0014353
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0014353
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: