Healthcare Provider Details

I. General information

NPI: 1083284194
Provider Name (Legal Business Name): VILLAGE PHYSICAL THERAPY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2979 UINTA ST
DENVER CO
80238-3959
US

IV. Provider business mailing address

5825 DELMONICO DR
COLORADO SPRINGS CO
80919-2242
US

V. Phone/Fax

Practice location:
  • Phone: 720-787-7800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: A'NNA GAYLORD
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 678-981-3543