Healthcare Provider Details

I. General information

NPI: 1942848734
Provider Name (Legal Business Name): COLORADO PHYSICAL THERAPY SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2019
Last Update Date: 12/16/2019
Certification Date: 12/16/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 BATTLECREEK DR UNIT A
FORT COLLINS CO
80528-5120
US

IV. Provider business mailing address

210 W MAGNOLIA ST STE 110
FORT COLLINS CO
80521-2915
US

V. Phone/Fax

Practice location:
  • Phone: 970-221-1201
  • Fax: 800-675-0273
Mailing address:
  • Phone: 970-221-1201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SUSAN CAROLINE FLYNN
Title or Position: DIR. OF HR AND FINANCE
Credential: PT, DPT
Phone: 970-221-1201