Healthcare Provider Details

I. General information

NPI: 1962349720
Provider Name (Legal Business Name): FREEDOM PERFORMANCE PHYSIO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

371 INDIAN RD
GRAND JUNCTION CO
81501-3819
US

IV. Provider business mailing address

683 EADIN LN
GRAND JUNCTION CO
81504-5899
US

V. Phone/Fax

Practice location:
  • Phone: 970-639-0579
  • Fax:
Mailing address:
  • Phone: 970-639-0579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: TYLER JONES
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 970-639-0579